The concept of 'quality of life' has had a paradigmatic effect in psychosomatic medicine by focussing on the measurements of psychological distress. This concept has been phenomenologically described under such names as discomfort and psychological boredom. Elements of fatigue, anxiety and depression seem to be core symptoms of dysfunctions in quality of life. An objective and nomothetic approach to quality of life has been demonstrated in this review when referring to the instrumental use of rating scales, e.g. the General Health Questionnaire. Furthermore, it has been recommended to follow the multiaxial approach of DSM-III including dimensions of personality, psychosocial stressors and social functioning.