There is little knowledge of the predictors of objective and subjective quality of life. To describe changes at 2 and 6 years in objective and subjective quality of life in 261 individuals attending a community mental health service and to identify predictors of change in each life domain. Prospective study of demographic, diagnostic and service utilisation characteristics, psychopathology, functioning, disability, self-esteem, affect balance and service satisfaction. Female gender, unmarried status, older age, less education and greater disability predicted a worsening of objective quality of life over time, but explain a small amount of variance. The variance in subjective quality of life was higher (>40%). Greater clinician-rated anxiety and depressive symptoms had a negative effect on satisfaction with health and general well-being. Psychological status, self-esteem and satisfaction with service were the most important predictors in almost all subjective domains; these variables should be important targets for treatment. This study is the first to provide information to enable clinicians to make prognostic judgements about quality of life and plan effective therapeutic strategies to improve quality of life.
