Quality of Life Deficit Is a Core Presentation of Functional Psychoses

Abstract

Patients with functional psychoses (FP) exhibit an exceedingly wide range of symptoms, and a broad spectrum of cognitive and functional impairments. In addition, it has become increasingly apparent that functional psychoses are, to variable degrees, accompanied by health-related quality of life (HRQL) impair- ments. This chapter addresses the question of whether the HRQL impairment or deficit is a syndrome in FP. The literature, as well as new and previously published findings from the Shaar Menashe Longitudinal Study of Quality of Life will be presented. I argue that a HRQL deficit is highly prevalent and fairly marked in FP patients. The HRQL impairment has been observed before individuals exhibit signs and psychotic symptoms of schizophrenia and it is relatively stable throughout the course of the illness. This syndrome appears to be relatively independent of symp- tomatology and neurocognitive deficits. Finally, the author suggests that impairment in general and domain-specific quality of life in particular are sufficiently reliable, stable, and specific enough syndrome to warrant inclusion in the diagnostic cri- teria for FP. Limitations in the current knowledge in this area are identified, and suggestions for future research are provided.