Quality of life has been found to be associated with social networks in patients with psychiatric disorders. We aimed to determine whether quality of life was related to social network size in a group of severely mentally ill subjects living in the community. In a population-based, prospective controlled study of two sector mental health teams in South London, a random sample of representative 1-year prevalent cases of non-organic psychosis was identified. Patients were interviewed at baseline, and associations between quality of life and social network size were analysed cross-sectionally. For average quality of life there was an increase up to a certain level of social network size (about 20 social contacts). For the quality of life subscore on social relations there appeared to be an optimal middle level of network size (10–12), with lower subscores for smaller and larger networks. Multivariate analysis confirmed the associations between quality of life and social network size. In analyses of network subgroups the importance of confiding contacts was underlined.

BACKGROUND:We report the impact on the quality of life (QOL) of people with psychosis of an intensive compared with a standard model of community care.METHOD:People with psychosis, in two sectors in south London, were interviewed with a variety of measures at baseline, and at two-year follow-up (n = 138). After baseline, services within one sector were reorganised, and a more intensive model of community care was introduced. QOL was measured using the Lancashire Quality of Life Profile.RESULTS:The two overall QOL measures, global QOL and the average of the domain-specific scores, were remarkably stable over time. There was weak evidence for an improvement in living situation domain in the intensive sector; this may be accounted for by a large drop in in-patient admissions. In both sectors objective QOL was poor, and there was little change in any of the objective indicators except in-patient admissions, and a suggestion of increased social activity in the intensive sector.CONCLUSIONS:We failed to find an effect of intensive community care on QOL in people with psychosis. This may indicate an insensitivity to change in QOL measures, or that the intervention failed to produce the kind of changes in mental health and functioning which would be reflected in improved QOL.

This study compared the subjective and objective quality of life and needs of patients with paranoid schizophrenia between inner city areas in Berlin (69 patients) and London (75 patients). Quality of life was assessed by means of the Lancashire Quality of Life Profile (German version Berliner Lebensqualitatsprofi), and need was quantified using the Camberwell Assessment of Need (German version Berliner Bedurfnisinventar). The hypotheses tested were that although Berlin patients may rate more highly on objective quality of life measures, the subjective quality of life would be similar as patients would judge their quality of life against their local expectations. The findings supported the first part of the hypothesis as on the objective measures the Berlin group was significantly better off financially and in living conditions, and had significantly fewer material needs. However, despite having more severe psychopathology, the Berlin groups' scores on global subjective quality of life were also higher. On particular life domains, subjective quality of life did not always reflect objective measures and sometimes went in the reverse direction. We concluded that the relationship between subjective and objective quality of life is complex, and great caution must be exercised in making quality of life comparisons between different cultures.