The Impact of Severe Mental Illness on Quality of Life: Challenges for Research and Practices

Michael S Ritsner
Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), The National Insurance Institute, Haifa, Israel

Series: Mental Illnesses and Treatments
BISAC: PSY022000

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This monograph deals with the health-related quality of life deficit (QOL) of people with severe mental disorders, focusing on issues related to its concept, characteristic profile, on developing the Distress/Protection Vulnerability Quality of Life Model including vulnerability (neurobiological and genetic), primary, and secondary factors, as well as on challenges for research and practice. The aim of this book is to provide a state of the art overview for QOL of people with severe mental disorders such as schizophrenia, schizoaffective disorders, major depressive disorder and bipolar disorder. In addition to a comprehensive overview of the latest achievements in the study of QOL, the book contains a detailed analysis of the following factors using comprehensive data from the Sha’ar Menashe Quality of Life Projects: symptom severity, emotional and somatic distress, functional capacity, suicidal behavior, circadian rhythms and sleep disturbances, antipsychotic drugs and adverse effects, neurocognitive deficit, awareness of illness, coping strategies, perceived social support, personality traits, lack of pleasure (anhedonia), and perceived health care needs. Analyzed samples included findings from clinical trials and cross-sectional and ten-year follow up studies of people with schizophrenia, schizoaffective disorders and mood disorders. The present book contributes to the literature in this field by making suggestions for improving research endeavors and clinical practice. Future research needs to address QOL deficits in all its multifaceted complexity so that it becomes clearer what the concept encompasses. (Imprint: Nova Biomedical)

Preface

Acknowledgment

Part I. Quality of Life: Meanings and Values

Chapter 1. Methodological and Conceptual Issues

Chapter 2. Measuring the Value of Quality of Life

Chapter 3. Schizophrenia and Mood Disorders

Chapter 4. Quality of Life Research Projects

Chapter 5. Quality of Life Profiles

Chapter 6. Temporal Patterns in Quality of Life

Part II. Illness-Related Indicators

Chapter 7. Clinical Manifestations

Chapter 8. Emotional and Somatic Distress

Chapter 9. Functional Capacity

Chapter 10. Suicidal-Related Behaviors

Chapter 11. Circadian Rhythm Disruption

Chapter 12. The Impact of Adverse Drug Reactions

Chapter 13. The Role of Cognitive Impairment

Part III. Personality-Related Traits

Chapter 14. Awareness of Illnesses

Chapter 15. Coping Strategies

Chapter 16. Self-Constructs

Chapter 17. Perceived Social Support

Chapter 18. Personality Dimensions

Chapter 19. Lack of Pleasure (Anhedonia)

Part IV. Enhancing the Quality of Life

Chapter 20. Perceived Health Care Needs

Chapter 21. Predicting Quality of Life Deficits

Chapter 22. The Distress/Protection Vulnerability Model

Chapter 23. What is the Treatment?

Chapter 24. Summary and Future Directions

About the Author

Index

“Professor Michael Ritsner has done the allied fields of psychiatry, epidemiology, genetics, and related disciplines a huge service in providing an incisive yet comprehensive study of health-related quality of life deficits of people with severe mental disorders. Understanding the experience of those affected with severe mental disorders and how that experience impacts their life course has often been an area of unsystematic speculation, but Professor Ritsner transcends prior efforts and dissects this topic with vast amounts of empirical data and the clarity of a world-class scientist. He wrestles with the multiple dimensional determinants of quality of life as a construct, predictor, and outcome indicator with rigor, richness, and nuance. His views on this critical topic are wise and prescient.” - Mark F. Lenzenweger, PhD; Distinguished Professor of Psychology, The State University of New York at Binghamton, and Professor of Psychology in Psychiatry (Adjunct), Weill Cornell Medical College, NY, USA

"Across 24 chapters this comprehensive volume offers readers an outstanding state of the art understanding of the myriad of phenomenon which influence the quality of life of persons diagnosed with serious mental disorder. There is essential and readily assessable information for practitioners, scientists and policy makers that enables a new and human understanding of the life and needs of this often-marginalized group and which can guide the way for increasingly humane and effective mental health treatments." - Paul H. Lysaker, Ph.D., Staff Psychologist, Roudebush VA Medical Center and Professor of Clinical Psychology, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA

"An excellent, comprehensive overview about quality of life in severe mental disorder. It is not only about quality of life measurement in scientific research, it’s about how to get a comprehensive understanding of quality of life, its origin and development and how to bring this important concept into clinical practice in order to close the gap between the subjective perspective of our patients and expert-rated outcomes in health care." - Prof. Dr. Anne Karow, Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany

"Mental illness has a profound impact on functioning and quality of life and those with severe forms of illness tend to experience long-term deficits in these areas. Dr. Ritsner, an eminent psychiatrist and researcher, provides a valuable, holistic and comprehensive review of current knowledge on severe mental illness and their impact on quality of life. Furthermore, the review provides an excellent evaluation of vulnerability and mitigating factors, as well as optimal treatment strategies and future research perspectives. This book is highly informative and would be welcomed by clinicians of different disciplines working in mental health, as well as academics equally. In addition, it fills an important unmet need for a comprehensive source on the topic for the lay public." - Arun V. Ravindran, MB, MSc, Ph.D.; Professor and Director, Global Mental Health Affairs & The Office of Fellowship; Training, Department of Psychiatry Graduate Faculty, Institute of Medical Sciences University of Toronto, Canada

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Chapter 23

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Audience: Researches, psychiatrists, psychologists, neurologists, neuroscientists, pharmacologists, graduate students, health care providers and policy makers in the fields of mental health and rehabilitation

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