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Subjective Perspectives

Subjective Perspectives

This domain consists of multiple elements, ranging from well-being and quality of life to preference of medications to awareness of the illness. Representative rating scales would include the subjective well-being under neuroleptics: SWN40 (short version of 20 items), drug attitude inventory: DAI41 (short version of 10 items), MOS 36-item short-form health survey: SF-3642 or its shorter 12-item version: SF-12,43 the WHO Quality of Life-BREF: WHOQOL-BREF44 (26 items), and the Scale to Assess Unawareness of Mental Disorder: SUMD45 (20 items), although they have not been commonly utilized (only in <10% of the studies).

In practice, it is possible that patients with substantial symptoms and impairments may regard their lives as ‘good’.46 In contrast, a report indicating that psychosocial functioning was negatively associated with self-esteem and satisfaction with life47 might not argue against the possibility that patients with relatively higher functioning could face reality, to recognize a hardship in life. As such, the difficulty in measuring QOL in this population makes some standardized evaluations complicated (e.g., QALY).48 It is also important to be aware of the strengths and weaknesses of subjectively completed versus objectively assessed rating scales regarding this issue.49 A QOL in patients is a complex construct50 and therefore, these scales may have a room for improvement to more nicely represent subjectivity on the side of patients.51


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