Změna subjektivní kvality života a klinického stavu v průběhu psychiatrické hospitalizace. Existují rozdíly mezi diagnostickými kategoriemi?

Modern medicine pursues more holistic approach to patients health. This study focuses on changes of subjective quality of life in main psychiatric diagnostic categories during psychiatric hospitalization and in relation to clinical variables. Methods: 150 patients hospitalized at Prague Psychiatric Center participated in the study. Quality of life (QOL) was assessed by Schwartz Outcome Scale, severity of symptoms by Clinical Global Impression scale. Results: The highest and lowest subjective QOL at admission was reported by patients with schizophrenia and mood disorders respectively. The highest difference between patients and psychiatrists in rating of severity of the disease was in subjects with schizophrenia. Both subejctive QOL and severity of the disease improved during hospitalization in all diagnostic categories. The highest improvement in both variables occured in patients with mood disorders. The smallest improvement in quality of life was found in patients with schizophrenia, despite significant clinical improvement. Patients with anxiety disorders rated their clinical improvement as significantly lower then their psychiatrists. These patients also reported the lowest subjective QOL at discharge. Clinical improvement correlated with improvement in subjective QOL only in patients with mood disorders. Discussion: Main psychiatric diagnostic categories differ in subjective health related quality of life and in its association with treatment. Differences may be related to low insight in psychotic patients, agravation of anxiety before discharge in patients with F4x and depressive symptoms in patients with mood disorders.