Quality-of-life ratings in patients with chronic illnesses

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Abstract
To the Editor. —Chronically ill patients can adapt psychologically to their illnesses. Cassileth et al1 found that 5 groups of physically ill patients (those with arthritis, diabetes, cancer, renal disease, and dermatologic disorders) did not differ significantly from one another or from the general public with regard to their mental health scores. These data, as well as studies of patients with end-stage renal disease, demonstrate that chronically ill patients have a remarkable capacity to adapt to their illness and generally will report better quality of life than individuals in the general population who are asked to imagine themselves having a chronic illness and to rate their imagined quality of life.1,2 We extend these findings by demonstrating that when chronically ill patients undergo an intervention to improve their health status, they too lower their assessment of their preintervention quality of life. We performed a cohort analytic study to assess quality

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