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The existing health-related quality of life questionnaires on multiple sclerosis (MS) only partially reflect the patient's point of view on the reduction of activities of daily living. Their development and validation was not performed in different languages. That is what prompted the development of the Multiple Sclerosis International Quality of Life (MusiQoL) Questionnaire as an international multidimensional measurement instrument. This paper presents this new development and the results of the German subgroup versus the total international sample.A total of 1,992 MS patients from 15 countries, including 209 German patients, took part in the study between January 2004 and February 2005. The patients took the MusiQoL survey at baseline and at 21±7 days as well as completing a symptom-related checklist and the SF-36 short form survey. Demographics, history and MS classification data were also generated. Reproducibility, sensitivity, convergent and discriminant validity were analysed.Convergent and discriminant validity and reproducibility were satisfactory for all dimensions of the MusiQoL. The dimensional scores correlated moderately but significantly with the SF-36 scores, but showed a discriminant validity in terms of gender, socioeconomic status and health status that was more pronounced in the overall population than in the German subpopulation. The highest correlations were observed between the MusiQoL dimension of activities of daily living and the Expanded Disability Status Scale (EDSS).The results of this study confirm the validity and reliability of MusiQoL as an instrument for measuring the quality of life of German and international MS patients.

In this paper the impact of the study design and the sampling procedure on the assessment of the costs of schizophrenia treatment will be analyzed. The study sample consists of 307 patients with the diagnosis of schizophrenia (ICD 10F20) with the age between 18 and 65 years. Study participants were recruited consecutively in inpatient and outpatient treatment settings and in accommodation facilities according to the proportions of patients treated in these settings in Leipzig which have been assessed before. Treatment costs have been assessed by means of the German version of the Client Sociodemographic and Service Receipt Inventory at five follow-ups at six-months intervals. For the whole study period significant differences of the mean service costs due to the recruitment setting have been found. The mean yearly costs amounted to 44.669 DM for participants recruited in sheltered accommodation, 27.975 DM for participants in inpatient treatment and 5691 DM for patients in outpatient facilities. A random-effect regression model confirmed significant effects of the recruitment setting over all five follow-ups. Additionally, the variance of costs over time indicates that cost assessment by means of cross sectional data involves the danger of errors due to random dispersion.

The prevalence of chronic pain in the general population ranges from 10% to over 40%, depending on the investigation and definition. Chronic pain is tied to high direct and indirect costs for the health care system on the one hand and considerable personal impairment of the quality of life on the other. The present paper provides an overview of the frequency and distribution of chronic pain in the general population and among those receiving treatment. The limitations of epidemiological investigations lie in the difficulty of validly assessing subjective internal experiences of the patients. Moreover, it is not possible to make diagnoses in the proper sense. In contrast, the examination of patients seeking and receiving treatment offers a further diagnostic differentiation and better assessment of the qualitative aspects of the pain experience. However, the meaningfulness of these studies is also limited due to the qualitative problems. Despite the methodological limitations of the studies investigated, the wide distribution and meaning of chronic pain becomes clear particularly when evaluating studies on the general population and populations receiving treatment.