Development of the Japanese version of the Manchester short assessment of quality of life (MANSA) among people with self-reported severe mental illness

The Manchester Short Assessment of Quality of Life (MANSA) is a quality-of-life (QOL) instrument developed for people with mental illness. This study aimed to develop a Japanese version of the MANSA for people with severe mental illness (SMI) and examine associations between individual MANSA domains and psychiatric diagnosis. The MANSA includes 12 self-rated subjective QOL items; the overall score is their mean on a 1–7 scale. We prepared a Japanese translation and tested validity and reliability using cross-sectional survey data from 237 adults with SMI in Japan. Concurrent validity was tested in 38 respondents who also completed the WHOQOL26. The sample was randomly split for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) in separate subsamples. Analyses included score distributions, validity, internal consistency, and domain-level ordinal logistic regression. The MANSA items showed the expected associations with the relevant scales and items. Although a two-factor structure was supported by EFA, the CFA fit indices were CFI = 0.86, TLI = 0.82, and RMSEA = 0.12. In the one-factor EFA solution, all factor loadings exceeded 0.40. Cronbach’s alpha for all 12 items was 0.877. The schizophrenia-spectrum group had higher scores in several domains than the bipolar- and depressive-disorder groups, and symptom stability was associated with higher scores across all domains. The Japanese version of MANSA showed acceptable concurrent validity and internal consistency. The proposed two-factor structure was not supported; total-score use remained reasonable, but further validation is needed. Diagnosis and symptom stability were associated with domain-specific QOL. People with severe mental illness need quality-of-life measures that reflect the areas of life most relevant to their experiences. However, Japan has lacked a validated Japanese version of an international mental-health-specific measure. We translated the Manchester Short Assessment of Quality of Life (MANSA) into Japanese and evaluated it in 237 adults receiving treatment for severe mental illness. The Japanese version showed acceptable relationships with other quality-of-life and self-esteem measures and good internal consistency. The overall MANSA score was better supported than the previously proposed two-factor structure. MANSA scores also differed across diagnostic groups, and respondents who reported more stable symptoms had higher scores in every domain. These findings suggest that the Japanese version of MANSA can be used to assess overall and domain-specific quality of life, although its factor structure should be examined further in larger, clinically characterized samples.