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Quality-of-life measurement in depression trials: A consumerist relic

McPherson, Susan and Oute, Jeppe and Speed, Ewen (2022) 'Quality-of-life measurement in depression trials: A consumerist relic.' Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. p. 136345932210748. ISSN 1363-4593

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Quality-of-life measurement in depression is advocated as a patient-centred indicator of recovery, but may instead enhance the mimetic authority of randomised controlled trials (RCTs) which have been roundly critiqued in mental health. In this paper we draw on the social life of methods approach to extend the well-developed critique of RCTs into the field of quality-of-life measurement. We accomplish this through consideration and critique of the conceptual and epistemological development of quality-of-life measurement in depression, including the role of psychometrics in its development. Examining conceptual developments from the 1970s onwards, we consider how the scientific literature on quality-of-life in depression aligns with behavioural economics and consumerism but falls short of engaging with genuinely patient-centred approaches to recovery. We argue that quality-of-life measures in depression were developed within a consumerist model of healthcare in which the medical model was a central pillar and ‘choice’ a rhetorical device only. While quality-of-life instrument development was largely funded by industry, psychometrics provided no coherent solution to the ‘affective fallacy’ (high correlations between quality-of-life and depressive symptoms). Industry has largely abandoned the measures, while psychotherapy research has increasingly endorsed them. We argue that in their design and implementation, quality-of-life measures for depression remain based on a commercial model of healthcare, are conceptually flawed and do not support concepts of patient-centred healthcare.

Item Type: Article
Uncontrolled Keywords: issues in research methodology; mental health; quality of life
Divisions: Faculty of Science and Health
Faculty of Science and Health > Health and Social Care, School of
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 09 Feb 2022 16:30
Last Modified: 16 Feb 2022 19:10

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