Intended for healthcare professionals

The Quality Of Life

An elusive concept?

BMJ 2000; 321 doi: (Published 23 December 2000) Cite this as: BMJ 2000;321:1575
  1. John Ashton, professor
  1. Public Health and Policy Directorate, NHS Executive North West, Millennium Park, Birchwood, Warrington WA3 7QN

“Happiness is a warm gun” wrote John Lennon many years ago, and millions of us still wish he hadn't, for it may have been the seed that was planted in Mark Chapman's disturbed mind to surface sometime later as an assassin's hand on the trigger outside the Dakota buildings in New York.

Yet happiness is an elusive concept, rather like love. As a young psychiatric registrar struggling to make sense of extreme mental states including mania and acute schizophrenia, I suggested to my consultant that if we were to understand the processes involved in hypomanic states we might do well to study acute infatuation and romantic love. Not for the first time I was thought to be off the wall. Years later, however, a Scandinavian colleague lent validity to my musings when he claimed …

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