ABSTRACT
We developed and validated a self-administered questionnaire (Subjective Quality of Life Analysis, S.QUA.L.A.) to measure subjective quality of life. S.QUA.L.A. is a multidimensional instrument. This scale includes 22 domains of life. It covers traditional areas (food, family relation etc)., and more abstract aspects of life (politic, justice, freedom, truth, beauty and art, love). For each domain, patients are asked to evaluate their degree of satisfaction. They have also to indicate how important this domain is for them. We questioned 92 patients with schizophrenia and 357 para-medical students. The research demonstrated reproducibility, high internal consistency reliability, and sensitivity to change. Principal components analysis with varimax rotation was performed. A five-factor solution was selected, showing a great contribution of different dimensions of the self. Determinants of quality of life were identified by using correlations with Lehman's Quality of Life Interview (QOLI), and with measures of psychopathology and social functioning. Satisfaction approach and QOLI showed the same construct. We confirmed the influence of symptoms of depression and anxiety on subjective quality of life assessment, and the poor impact of disease parameters.
Subject(s)
Psychotic Disorders/diagnosis , Quality of Life/psychology , Schizophrenia/diagnosis , Schizophrenic Psychology , Surveys and Questionnaires , Adolescent , Adult , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales/statistics & numerical data , Psychometrics/statistics & numerical data , Psychotic Disorders/psychology , Reproducibility of Results , Social Adjustment , Statistics as TopicABSTRACT
We suggest in a phenomenological perspective to consider schizophrenia as a special form of human temporality. From this perspective, we view the symptoms of schizophrenia as actions undertaken by subjects to stabilize themselves in existence. From this vantage, we describe the clinical expression of the disorder as a type of "existential impatience", characterized by a painful and elusive "now". This present time posits the prime moment of the constitution of the person. Existential impatience reflects from our patients the persistence of excessive efforts towards individuation. Schizophrenia. In human life in general, individuation consists in an unceasing dynamic process of building up of the self. This process starts with the non-self and particularly with the other. Therefore, the emergence of any relation within the self is grounded in the relation with the other and is based on the relation the other establishes with himself. Schizophrenia distinctly displays the two constitutive moments of "being oneself." These moments are generally linked for all of us: an "unending coming to oneself" (difference of identity), and a "continuous maintenance of being a self" (identity of difference). Existential impatience is not only an irritability of a formal order. Existence itself is impatient in the schizophrenic experience as it hastens to reach human goals while trampling on an "ante-festum" temporal mode. This "before-the-feast" temporal structure is dominated by the shiver before an unknown future, a sign of a basic quest for a task. Schizophrenic "ante-festum" is both a constant fear of being unable to come to oneself and a desperate effort to reach this unknown future. If psychopathology claims to settle [establish] that "order" and "measure" would constitute the two fundamental anthropological bases of human being, impatience of existence draws the emblematic figure of the disorder of measure as a referential motion of the birth of any temporalisation. Such considerations suggest the value, in treatment and rehabilitation, of praising patience and focusing on building, or re-building, the past. The main objective is to reach a maieutics of the self based on relationships in the community and with care-givers, all within an accompanying structured, daily framework.
