Quality of Life in Psychiatric Patients

Ancient Indian Literature considers health as a broad and global concept represented by from independent dimensions of physical, psychological, social and spiritual well being (Charak Samhita,1949). This conceptualisation of health is even broader than the modern concept of health as accepted by WHO which aims at restoring "a state of complete physical, mental and social well being". Till the turn of last century the main focus of treatment was on saving the lives but with the development of medicine as a science there has been a conceptual shift from simply treating the. symptoms and prolonging life to improving the QOL of the patients. Chronic illnesses have replaced life threatening conditions as major challenges to clinicians and have brought with them issues such as: cost of treatment, disability, social impairment and burden of care. These issues directly or indirectly influenced the patients sense of well being and self esteem. A number of factors have contributed to sucn development life threatening conditions have been replaced by chronic illnesses and with this the cost of treatment/care has become an important parameter. Cost utility, the concept which involves choice between different methods of treatment based on improvement it provides and the quality of life it gives, is increasingly in use in health care evaluations. In addition, family and patient's groups participation in decision about health care is also being seen as their desire to get therapies for better quality of life. The pharmaceutical industry has been quick to seize the opportunity and is motivated by genuine desire to develop better medications so that they can give better QOL to the patients. After all what matters for the individual patient with a chronic illness is how such an individual feels and functions on long term drug therapy. The concept of quality of life is not so new. However, in its current form it was launched by late American President, Lyndon B. Johnson, during his presidential campaign in 1964, when he gave the idea that people were entitled to "a good quality of life". Thereafter, quality of life has been recognised as one of the mankind's fundamental needs. Initially, only few knew exactly what it meant, but it was evident from its wider acceptance that this concept was an important one. In simple words quality of life is a person's own subjective view of well being and satisfaction with his/her life. It is therefore completely subjective feeling state (Joyce, 1992). Rehumanising medicine and freeing it of high tech objective is the goal of the proponents of quality of life concept.