Assessment of Quality of Life in Psychosomatic and Neurotic Patients : A study using the Quality of Life Scale(QOLS)

Abstract

The purpose of this study was to examine the characteristics and disruptions in the quality of life (QOL) of psychosomatic patients and compare them with neurotic patients and normal samples. Method : A self-rated quality of life scale (QOLS) developed by the authors to measure subjective well-being was administered to psychosomatic (n=21) and neurotic (n=24) outpatients and normal controls (n=86). The 31 item QOLS is constructed with six subscales representing six factors extracted through factor analysis. (Factor I : Meaning of Life and Hopeful Expectations about the Future, Factor II : Enjoyable Life and Work Satisfaction, Factor III : Peace of Mind and Subjective Health, Factor IV : Satisfaction with Financial Status and Environment. Factor V : Satisfaction with Close Relationships. Factor VI : Self-Esteem and Social Support). Cronbach's alpha coeficient for the scale was O. 89. The mean QOLS total scores and six subscale scores of the three semple groups were tested by analysis of variance and then compared by Scheffe's method. The scores were further subjected to discriminant analysis to delineate the characteristics of the QOL of psychosomatic patients. Results : The mean QOLS total score and all but one (Factor IV ) subscale score were highest in the normal control group and lowest in the neurotic group, with those of psychosomatic group located in between. However none of the differences in scores between psychosomatic and normal groups reached statistical significance. Between the normal and neurotic groups, the total and three subscale scores were statistically significant (Total p<0. O1,Factor II p<0. OOl, III p< O. Ol, III p<0. O1). Between psychosomatic and neurotic groups, the scores were siguificantly different only in one subscale (Factor II p<0. 05). Diseriminant analysis of the scores showed that the item most powerfully discriminating psychosomatic and neurotic groups was the question related to energy (Factor II ). The results of our study indicate that in psychosomatic illnesses, in which psychosocial stressors affect physieal condition, patients' QOL is less disrupted than in neuroses, in which patients' psychological well-being is directly attacked, especially in the areas of morale. This might reflect the alexithymic tendencies which are often said to be associated with psychosomatic disorders. The issue of the interaction between alexithymia and QOL awaits further investigation.