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Zhou DN, Yang X, Wang W, Jin WQ, Tang YL, Zheng Z, Ren Y. Exploring the interplay of psychiatric symptoms, antipsychotic medications, side effects, employment status, and quality of life in Chronic Schizophrenia. BMC Psychiatry 2024; 24:484. [PMID: 38956530 PMCID: PMC11220993 DOI: 10.1186/s12888-024-05929-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Many factors contribute to quality of life (QoL) in patients with schizophrenia, yet limited research examined these factors in patients in China. This cross-sectional study explores subjective QoL and its associated factors in patients. METHODS The QoL was assessed using the Schizophrenia Quality of Life Scale (SQLS). Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) and seven factors were extracted. Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety. Cognitive impairment was assessed using the Ascertain Dementia 8 (AD8). The Treatment Emergent Symptom Scale (TESS) and Rating Scale for Extrapyramidal Side Effects (RSESE) were used to evaluate the side effects of medications. RESULTS We recruited 270 patients (male:142,52.6%, mean age:41.9 ± 9.4 years). Positive correlations were observed between SQLS and its subdomains with the total score of BPRS, PHQ-9, GAD-7, AD8, TESS, and RSESE (all P < 0.005). Patients who were taking activating second-generation antipsychotics (SGAs) had lower scores on total SQLS, Motivation/ Energy domain of SQLS (SQLS-ME) as well as Symptoms/ Side effects domain of SQLS (SQLS-SS) compared to those taking non-activating SGAs (all P < 0.005). Multiple regression analysis showed that depressive/ anxiety symptoms and cognitive impairment had significant negative effects on QoL (P ≤ 0.001), while activating SGAs had a positive effect (P < 0.005). Blunted affect and unemployment were inversely associated with the motivation/energy domain (P < 0.001). CONCLUSION Our findings emphasize the important role of depression/anxiety symptoms and cognitive impairment in the QoL of patients with chronic schizophrenia. Activating SGAs and employment may improve the QoL of these individuals. TRIAL REGISTRATION This protocol was registered at chictr.org.cn (Identifier: ChiCTR2100043537).
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Affiliation(s)
- Dan-Na Zhou
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xue Yang
- The First Psychiatric Hospital of Harbin, Harbin, Heilongjiang Province, China
| | - Wen Wang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wen-Qing Jin
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, 30033, USA
| | - Zhi Zheng
- Huai'an No. 3 People's Hospital, Huaian, Jiangsu Province, China.
| | - Yanping Ren
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, Beijing, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Mao Z, Tian L, Sun Y, Dong F, Wang C, Bo Q. Quality of life and its predictors in first-episode schizophrenia and individuals at clinical high-risk for psychosis. BMC Psychiatry 2023; 23:793. [PMID: 37907877 PMCID: PMC10617034 DOI: 10.1186/s12888-023-05303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND This is a cross-sectional study comparing the degree of subjective quality of life (QOL) impairment and its predictive factors in first-episode schizophrenia (FES) and individuals at clinical high-risk (CHR) for psychosis. METHODS Seventy-seven FES, 59 CHR, and 64 healthy controls (HC) were included. The QOL of all participants was assessed using the World Health Organization Quality of Life (WHOQOL)-Brief Form (BREF). Psychiatric symptoms of individuals with FES were assessed with the Positive and Negative Syndrome Scale (PANSS), five factors were further identified through factor analysis; for individuals with CHR and HC, the Scale of Prodromal Symptoms (SOPS) was used. RESULTS The total and four sub-domain scores of the WHOQOL-BREF in the FES and CHR groups were lower than those of the HC group. The overall and psychological health scores in the CHR group were lowest. In the FES group, after applying Bonferroni's correction, there is a negative correlation between the total QOL scores and anxiety/depressive symptom scores (r = -0.34, P = 0.003). The stepwise multiple regression analysis showed that the QOL of both FES and CHR group were negatively affected by anxiety/depressive symptoms and unemployment (P < 0.05). CONCLUSIONS Compared with FES, CHR individuals are more dissatisfied with their QOL. Although diagnostic assessment of FES and CHR relies heavily on positive symptoms, the QOL is more affected by anxiety/depressive symptoms and social functioning.
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Affiliation(s)
- Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Lu Tian
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Fang Dong
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
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Sturm ET, Thomas ML, Sares AG, Dave S, Baron D, Compton MT, Palmer BW, Jester DJ, Jeste DV. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Disorders: II. Assessments. Schizophr Bull 2023; 49:851-866. [PMID: 37022911 PMCID: PMC10318889 DOI: 10.1093/schbul/sbad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
BACKGROUND AND AIMS Social determinants of health (SDoHs) impact the development and course of schizophrenia-spectrum psychotic disorders (SSPDs). Yet, we found no published scholarly reviews of psychometric properties and pragmatic utility of SDoH assessments among people with SSPDs. We aim to review those aspects of SDoH assessments. STUDY DESIGN PsychInfo, PubMed, and Google Scholar databases were examined to obtain data on reliability, validity, administration process, strengths, and limitations of the measures for SDoHs identified in a paired scoping review. STUDY RESULTS SDoHs were assessed using different approaches including self-reports, interviews, rating scales, and review of public databases. Of the major SDoHs, early-life adversities, social disconnection, racism, social fragmentation, and food insecurity had measures with satisfactory psychometric properties. Internal consistency reliabilities-evaluated in the general population for 13 measures of early-life adversities, social disconnection, racism, social fragmentation, and food insecurity-ranged from poor to excellent (0.68-0.96). The number of items varied from 1 to more than 100 and administration time ranged from less than 5 minutes to over an hour. Measures of urbanicity, low socioeconomic status, immigration status, homelessness/housing instability, and incarceration were based on public records or targeted sampling. CONCLUSIONS Although the reported assessments of SDoHs show promise, there is a need to develop and test brief but validated screening measures suitable for clinical application. Novel assessment tools, including objective assessments at individual and community levels utilizing new technology, and sophisticated psychometric evaluations for reliability, validity, and sensitivity to change with effective interventions are recommended, and suggestions for training curricula are offered.
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Affiliation(s)
- Emily T Sturm
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Anastasia G Sares
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | | | - David Baron
- Western University of Health Sciences, CA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, and New York State Psychiatric Institute, New York, NY, USA
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center, San Diego, CA, USA
| | - Dylan J Jester
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, CA, USA (Retired)
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Öngün E, Ünsal G, Karaca S. Meta-analysis of the effect of psychosocial skills training on the quality of life of people with schizophrenia. Perspect Psychiatr Care 2022; 58:2272-2285. [PMID: 35194796 DOI: 10.1111/ppc.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to synthesize the studies examining the effects of psychosocial skills training (PSST) on the quality of life of people with schizophrenia using a meta-analysis. DESIGN AND METHODS Fifteen studies were included in the meta-analysis according to the inclusion and exclusion criteria. FINDINGS PSST was found to have a moderate effect on the overall score of quality of life of individuals with schizophrenia, a moderate effect on the psychological dimension, and a low effect on the physical dimension. PRACTICE IMPLICATIONS It can be said that psychosocial skills training is an effective intervention that can be used to improve the quality of life of people with schizophrenia.
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Affiliation(s)
- Esen Öngün
- Department of Psychiatric Nursing, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Gül Ünsal
- Department of Psychiatric Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Semra Karaca
- Department of Psychiatric Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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He XY, Migliorini C, Huang ZH, Wang F, Zhou R, Chen ZL, Xiao YN, Wang QW, Wang SB, Harvey C, Hou CL. Quality of life in patients with schizophrenia: A 2-year cohort study in primary mental health care in rural China. Front Public Health 2022; 10:983733. [PMID: 36159297 PMCID: PMC9495714 DOI: 10.3389/fpubh.2022.983733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/17/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Quality of life (QoL) has been always an important way to evaluate the outcomes of schizophrenia, but there have been few previous longitudinal studies and few in middle-income countries. This study aimed to explore the QoL in Chinese patients with schizophrenia treated in primary mental health care and the risk factors of QoL over time. Methods Patients with schizophrenia treated in primary mental health care in rural/regional areas in Luoding, Guangdong, PR China, were evaluated with an extended questionnaire including the Chinese version of the World Health Organization Quality of Life (WHOQOL-BREF) at baseline and 2-year follow-up. Bivariate and multivariate analyses were conducted including Generalized Estimated Equation analyses (GEE). Results Four hundred and ninety-one patients with schizophrenia in primary care completed the 2-year follow up evaluation. The QoL physical, environmental, and social relationships domains showed improvement after the 2-year period, but the psychological domain did not. GEE results showed that earlier age of onset, older age, being employed, being unmarried, the thicker waist circumference, less use of clozapine or other SGAs, fewer hospitalizations, more frequent insomnia, more severe depressive and negative symptoms as well as worse treatment insight were independently associated with poor QoL in patients with schizophrenia. Conclusion According to our results, to improve the quality of life of patients with schizophrenia in primary care, we should pay more attention to the treatment of depression, negative and insomnia symptoms of schizophrenia, the choice and dosage of antipsychotic medication and improvement in the treatment compliance. The combined use of educational and behavioral strategies may improve treatment adherence.
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Affiliation(s)
- Xiao-Yan He
- Liuzhou Worker's Hospital, Liuzhou, China,Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Christine Migliorini
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Zhuo-Hui Huang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Fei Wang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Rui Zhou
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | | | | | - Qian-Wen Wang
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shi-Bin Wang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Cai-Lan Hou
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China,*Correspondence: Cai-Lan Hou ;
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Tan XW, Lim KWK, Martin D, Tor PC. Effects of electroconvulsive therapy on cognition and quality of life in schizophrenia. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:400-408. [PMID: 35906939 DOI: 10.47102/annals-acadmedsg.202292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The effects of electroconvulsive therapy (ECT) on quality of life (QoL), and its relationship with symptom and cognitive change remains unclear. We aim to examine the association of QoL changes with psychiatric symptom and cognitive changes among patients with schizophrenia who underwent ECT. METHODS This is a retrospective cohort study of 132 patients who received ECT from July 2017 to December 2019. Sociodemographic and clinical characteristics were obtained from medical records. Changes in QoL, psychiatric symptoms and cognition function were examined after 6 sessions of ECT. Generalised linear regression was used to examine the associations of Brief Psychiatric Rating Scale (BPRS) scores and Montreal Cognitive Assessment (MoCA) scores with QoL as measured by EQ-5D scores. RESULTS The mean (standard error) improvements after ECT were statistically significant for the assessment scales of EQ-5D utility score: 0.77 (0.02) to 0.89 (0.02), P<0.001; EuroQol-5-Dimension (EQ-5D) visual analogue scale score: 66.82 (2.61) to 73.05 (1.93), P=0.012; and EQ-5D subdomain scores. Both improvement in BPRS (adjusted β coefficient -0.446, 95% confidence interval [CI] -0.840 to -0.052) and MoCA (adjusted β 12.068, 95% CI 0.865 to 12.271) scores were significantly associated with improvement in EQ-5D utility scores after adjustment for sociodemographic and clinical characteristics. Improvement of BPRS scores (psychiatric symptoms) was significantly associated with improvement of the patients' mental health that was assessed by EQ-5D subdomain scores of pain (adjusted β coefficient 0.012, 95% CI 0.004 to 0.021) and anxiety (adjusted β coefficient 0.013, 95% CI 0.002 to 0.024). Improvement of MoCA scores (cognitive function) was significantly associated with patients' physical health as assessed by EQ-5D subdomain score of usual activity (adjusted β coefficient -0.349, 95% CI -0.607 to -0.09). CONCLUSION ECT was associated with an overall improvement of QoL among patients with schizophrenia. The improvement of psychiatric symptoms was found to be significantly associated with better mental health while the improvement of cognitive function was associated with better physical health.
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Affiliation(s)
- Xiao Wei Tan
- Department of Mood and Anxiety, Institute of Mental Health, Singapore
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Ehrminger M, Roux P, Urbach M, André M, Aouizerate B, Berna F, Bohec AL, Capdevielle D, Chéreau I, Clauss J, Dubertret C, Dubreucq J, Fond G, Honciuc RM, Lançon C, Laouamri H, Leigner S, Mallet J, Misdrahi D, Pignon B, Rey R, Schürhoff F, Passerieux C, Brunet-Gouet E. The puzzle of quality of life in schizophrenia: putting the pieces together with the FACE-SZ cohort. Psychol Med 2022; 52:1501-1508. [PMID: 32962773 DOI: 10.1017/s0033291720003311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The determinants of quality of life (QoL) in schizophrenia are largely debated, mainly due to methodological discrepancies and divergence about the concepts concerned. As most studies have investigated bi- or tri-variate models, a multivariate model accounting for simultaneous potential mediations is necessary to have a comprehensive view of the determinants of QOL. We sought to estimate the associations between cognitive reserve, cognition, functioning, insight, depression, schizophrenic symptoms, and QoL in schizophrenia and their potential mediation relationships. METHODS We used structural equation modeling with mediation analyses to test a model based on existing literature in a sample of 776 patients with schizophrenia from the FondaMental Foundation FACE-SZ cohort. RESULTS Our model showed a good fit to the data. We found better functioning to be positively associated with a better QoL, whereas better cognition, better insight, higher levels of depression, and schizophrenic symptoms were associated with a lower QoL in our sample. Cognitive reserve is not directly linked to QoL, but indirectly in a negative manner via cognition. We confirm the negative relationship between cognition and subjective QoL which was previously evidenced by other studies; moreover, this relationship seems to be robust as it survived in our multivariate model. It was not explained by insight as some suggested, thus the mechanism at stake remains to be explained. CONCLUSION The pathways to subjective QoL in schizophrenia are complex and the determinants largely influence each other. Longitudinal studies are warranted to confirm these cross-sectional findings.
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Affiliation(s)
- Mickael Ehrminger
- University Paris Saclay - UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France
- University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France
- University Paris Saclay, 'PsyDev' Team, CESP, Inserm, Villejuif, France
- Fondation Fondamental, Créteil, France
| | - Paul Roux
- University Paris Saclay - UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France
- University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France
- University Paris Saclay, 'PsyDev' Team, CESP, Inserm, Villejuif, France
- Fondation Fondamental, Créteil, France
| | - Mathieu Urbach
- University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France
- Fondation Fondamental, Créteil, France
| | - Myrtille André
- Fondation Fondamental, Créteil, France
- University Department of Adult Psychiatry, La Colombière Hospital, Montpellier, France
| | - Bruno Aouizerate
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), France
| | - Fabrice Berna
- Fondation Fondamental, Créteil, France
- Department of Psychiatry, University Hospitals of Strasbourg, Strasbourg, France
- University of Strasbourg, INSERM U1114, Strasbourg, France
| | - Anne-Lise Bohec
- Fondation Fondamental, Créteil, France
- University Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Center for Research in Neuroscience, PSYR2 Team, Le Vinatier Hospital, Bron, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France
- University of Montpellier, PSNREC, Neuropsychiatry: Epidemiological and Clinical Research, INSERM, Montpellier, France
| | - Isabelle Chéreau
- Fondation Fondamental, Créteil, France
- Department of Psychiatry, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Julie Clauss
- Fondation Fondamental, Créteil, France
- Department of Psychiatry, University Hospitals of Strasbourg, Strasbourg, France
- University of Strasbourg, INSERM U1114, Strasbourg, France
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France
- Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- University Paris Descartes, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- University Paris Diderot, School of Medicine, Sorbonne Paris Cité, Paris, France
| | - Julien Dubreucq
- Fondation Fondamental, Créteil, France
- Psychosocial Rehabilitation Reference Centre, Alpes-Isère Hospital, Grenoble, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France
- Department of Public Health, La Conception University Hospital, Marseille, France
- School of medicine, University of Aix-Marseille, EA 3279, Marseille, France
| | - Roxana-Mihaela Honciuc
- Fondation Fondamental, Créteil, France
- Department of Psychiatry, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Christophe Lançon
- Fondation Fondamental, Créteil, France
- School of medicine, University of Aix-Marseille, EA 3279, Marseille, France
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | | | - Sylvain Leigner
- Fondation Fondamental, Créteil, France
- Psychosocial Rehabilitation Reference Centre, Alpes-Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France
- Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- University Paris Descartes, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- University Paris Diderot, School of Medicine, Sorbonne Paris Cité, Paris, France
| | - David Misdrahi
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Baptiste Pignon
- Fondation Fondamental, Créteil, France
- INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Mondor University Hospital, Créteil, France
- School of medicine, University of Paris-Est, Créteil, France
| | - Romain Rey
- Fondation Fondamental, Créteil, France
- University Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Center for Research in Neuroscience, PSYR2 Team, Le Vinatier Hospital, Bron, France
| | - Franck Schürhoff
- Fondation Fondamental, Créteil, France
- INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Mondor University Hospital, Créteil, France
- School of medicine, University of Paris-Est, Créteil, France
| | - Christine Passerieux
- University Paris Saclay - UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France
- University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France
- University Paris Saclay, 'PsyDev' Team, CESP, Inserm, Villejuif, France
- Fondation Fondamental, Créteil, France
| | - Eric Brunet-Gouet
- University Paris Saclay - UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France
- University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France
- University Paris Saclay, 'PsyDev' Team, CESP, Inserm, Villejuif, France
- Fondation Fondamental, Créteil, France
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van Aken BC, Wierdsma AI, Voskes Y, Pijnenborg GHM, van Weeghel J, Mulder CL. The Association Between Executive Functioning and Personal Recovery in People With Psychotic Disorders. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac023. [PMID: 39144765 PMCID: PMC11206059 DOI: 10.1093/schizbullopen/sgac023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background Recovery in psychotic disorder patients is a multidimensional concept that can include personal, symptomatic, societal, and functional recovery. Little is known about the associations between personal recovery (PR) and functional recovery (FR). FR involves a person's ability to recover or compensate for impaired cognition, such as executive functions, and the loss of skills. Method In this cross-sectional study (the UP'S study), we used measures of executive functioning and personal recovery to assess a cohort of people with a psychotic disorder. PR was measured using the Recovering Quality of Life (ReQOL) and Individual Recovery Outcomes (I.ROC). FR was assessed using two forms of assessment. The Behavioral Rating Inventory of Executive Functioning Adult version (BRIEF-A) was used for self-rated executive functioning, and the Tower of London (TOL) for performance-based executive functioning. Regression models were calculated between executive functioning (BRIEF-A and TOL) and PR (ReQOL and I.ROC). Model selection was based on the Wald test. Results The study included data on 260 participants. While total scores of BRIEF-A had a small negative association with those of the ReQOL (β = -0.28, P > .001) and the I.ROC (β = -0.41, P > .001), TOL scores were not significantly associated with the ReQOL scores (β = 0.03, P = .76) and the I.ROC scores (β = 0.17, P = 0.17). Conclusion Self-reported EF, which measures the accomplishment of goal pursuit in real life was associated with PR. However, processing efficiency and cognitive control as measured by performance-based EF were not.
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Affiliation(s)
- B C van Aken
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, the Netherlands
| | - A I Wierdsma
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, the Netherlands
| | - Y Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, Amsterdam, the Netherlands
- GGz Breburg, Tilburg, the Netherlands
| | - G H M Pijnenborg
- Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - J van Weeghel
- Phrenos Centre of Expertise, Utrecht, the Netherlands
- Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, the Netherlands
- Parnassia Psychosis Research, Den Haag, the Netherlands
| | - C L Mulder
- Department of Psychiatry, Erasmus MC, Epidemiological and Social Psychiatric Research Institute, Rotterdam, the Netherlands
- Antes Mental Health Care, Rotterdam, the Netherlands
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9
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Wong SCY, Chang WC, Hui CLM, Chan SKW, Lee EHM, Suen YN, Chen EYH. Relationship of subjective quality of life with symptomatology, neurocognition and psychosocial functioning in first-episode psychosis: a structural equation modelling approach. Eur Arch Psychiatry Clin Neurosci 2021; 271:1561-1569. [PMID: 34304302 DOI: 10.1007/s00406-021-01309-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Subjective quality of life (SQoL) represents an important outcome of psychotic disorders. However, determinants of SQoL and their complex inter-relationships in the early course of illness remain to be clarified. Association between neurocognitive impairment and SQoL in first-episode psychosis (FEP) is understudied. This study employed structural equation modeling (SEM) to examine relationships among SQoL, depressive, positive and negative symptoms, neurocognition, and psychosocial functioning in FEP patients. Three hundred and forty-seven patients aged 25-55 years presenting with FEP to early intervention program in Hong Kong were recruited. Assessment encompassing symptom profiles, psychosocial functioning and a battery of neurocognitive tests were conducted. SF-12 mental component summary scores were computed as the primary measure of SQoL. Our correlation analyses revealed differential relationships between negative symptom subdomains and SQoL, with amotivation, but not diminished expression, being related to SQoL. Final SEM model yielded a good model fit (comparative fix index = 0.94; root mean square error of approximation = 0.05; standardized root mean square residuals = 0.07) and demonstrated that depression, positive symptoms and psychosocial functioning were directly associated with SQoL, with depression showing the strongest effect. Amotivation, neurocognition and positive symptoms had an indirect effect on SQoL via the mediation of psychosocial functioning. This study affirms depression as a critical determinant of subjective mental wellbeing, and underscores an intermediary role of psychosocial functioning in linking amotivation, neurocognitive impairment and positive symptoms to SQoL in FEP patients. Depression and functional impairment thus constitute as crucial therapeutic targets for improvement of SQoL in the early illness stage.
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Affiliation(s)
- Sandra Chi Yiu Wong
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong. .,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong.
| | - Christy Lai Ming Hui
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yi Nam Suen
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eric Yu Hai Chen
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
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10
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Brunet-Gouet E, Decaix-Tisserand C, Urbach M, Bazin N, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Dubertret C, Dubreucq J, Fond G, Lançon C, Leignier S, Mallet J, Misdrahi D, Pires S, Schneider P, Schurhoff F, Yazbek H, Zinetti-Bertschy A, Passerieux C, Roux P. Outcome prediction with a social cognitive battery: a multicenter longitudinal study. NPJ SCHIZOPHRENIA 2021; 7:30. [PMID: 34039999 PMCID: PMC8155046 DOI: 10.1038/s41537-021-00160-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/29/2021] [Indexed: 11/08/2022]
Abstract
The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.
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Affiliation(s)
- Eric Brunet-Gouet
- FondaMental Foundation, Créteil, France.
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France.
| | - Capucine Decaix-Tisserand
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Mathieu Urbach
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Nadine Bazin
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Bruno Aouizerate
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, Bordeaux, France
| | - Lore Brunel
- FondaMental Foundation, Créteil, France
- INSERM U955, Translational Psychiatry Team, Creteil, France
- Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), AP-HP, HU Henri Mondor, Creteil, France
| | - Delphine Capdevielle
- FondaMental Foundation, Créteil, France
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, Montpellier, France
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Isabelle Chereau
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil, France
- AP-HP; Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Inserm UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Paris, France
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - Julien Dubreucq
- FondaMental Foundation, Créteil, France
- Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Guillaume Fond
- FondaMental Foundation, Créteil, France
- La Conception Hospital, AP-HM, Aix-Marseille Univ., School of Medicine-La Timone Medical Campus, EA 3279: CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Christophe Lançon
- FondaMental Foundation, Créteil, France
- Ste Marguerite Hospital, AP-HM, Aix-Marseille Univ., School of Medicine-La Timone Medical Campus, EA 3279: CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Sylvain Leignier
- FondaMental Foundation, Créteil, France
- Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- FondaMental Foundation, Créteil, France
- AP-HP; Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Inserm UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Paris, France
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - David Misdrahi
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
| | - Sylvie Pires
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Priscille Schneider
- FondaMental Foundation, Créteil, France
- Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
- Inserm U1114, Strasbourg, France
| | - Franck Schurhoff
- FondaMental Foundation, Créteil, France
- INSERM U955, Translational Psychiatry Team, Creteil, France
- Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), AP-HP, HU Henri Mondor, Creteil, France
| | - Hanan Yazbek
- FondaMental Foundation, Créteil, France
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, Montpellier, France
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Anna Zinetti-Bertschy
- FondaMental Foundation, Créteil, France
- Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
- Inserm U1114, Strasbourg, France
| | - Christine Passerieux
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Paul Roux
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
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11
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Sum MY, Chan SKW, Tse S, Bola JR, Ng RMK, Hui CLM, Lee EHM, Chang WC, Chen EYH. Relationship between subjective quality of life and perceptions of recovery orientation of treatment service in patients with schizophrenia and major depressive disorder. Asian J Psychiatr 2021; 57:102578. [PMID: 33592390 DOI: 10.1016/j.ajp.2021.102578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/15/2021] [Accepted: 01/24/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between subjective quality of life (QOL) and the specific domains of perceptions of recovery orientation of treatment services in patients with schizophrenia and major depressive disorder (MDD). METHODS One hundred and seventy-nine patients with schizophrenia spectrum disorders and fifty-seven patients with MDD were recruited. Patients were assessed on subjective QOL, self-reported depressive symptoms, illness severity, functioning, and perception of recovery orientation of the service environment (RSA). A multiple linear regression model was used to assess the relationship between QOL and RSA score, controlling for all other factors. Spearman correlation analysis was used to examine the relationship between RSA domains and total QOL in each diagnostic group separately. RESULTS The regression model explained 47.4 % of the variance observed in total QOL. Depressive symptoms, functioning and RSA were significantly associated with total QOL in the model. Domains one (life goals) and five (individually tailored services) of the RSA were associated with QOL in both groups. Domains two (patient involvement) and three (diversity of treatment options) were associated with total QOL only in patients with schizophrenia. CONCLUSION Our findings highlight that perceptions of recovery orientation of service, depressive symptoms and functioning significantly affected the subjective QOL of patients with serious mental illness. The differential relationship observed between QOL and domains of RSA in patients with MDD and schizophrenia suggests that targeted interventions meeting the needs of different patient groups may be crucial to improve QOL of patients.
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Affiliation(s)
- Min Yi Sum
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Samson Tse
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong Special Administrative Region
| | - John R Bola
- Department of Applied Social Studies, City University of Hong Kong, Hong Kong Special Administrative Region
| | - Roger Man Kin Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong Special Administrative Region
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region
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12
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Shafie S, Samari E, Jeyagurunathan A, Abdin E, Chang S, Chong SA, Subramaniam M. Gender difference in quality of life (QoL) among outpatients with schizophrenia in a tertiary care setting. BMC Psychiatry 2021; 21:61. [PMID: 33509142 PMCID: PMC7842069 DOI: 10.1186/s12888-021-03051-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/13/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Patients with mental illness report lower quality of life (QoL) compared to the general population. Prior research has found several differences in clinical features and experiences of male and female patients with schizophrenia. Given these differences, it is also important to explore if there are any gender differences in terms of their QoL. This study aimed to investigate differences in QoL between and within each gender among outpatients with schizophrenia in Singapore. METHODS A total of 140 outpatients were recruited through convenience sampling at the Institute of Mental Health, Singapore. QoL was measured using the brief version of World Health Organization Quality of Life (WHOQOL-BREF) which consists of four domains: physical health, psychological health, social relationships, and environment. QoL scores of males and females were compared using independent t-tests, and multiple linear regressions were used to examine sociodemographic correlates of QoL in the overall sample and within each gender. RESULTS There was no significant difference in QoL domain scores between genders. Among males, Indian ethnicity (versus Chinese ethnicity) was positively associated with physical health (β=3.03, p=0.018) while males having Technical Education/ Diploma/ A level education (versus Degree and above) were positively associated with social relationships domain (β=2.46, p=0.047). Among females, Malay ethnicity (versus Chinese ethnicity) was positively associated with physical health (β=1.95, p=0.026) psychological health (β=3.21, p=0.001) social relationships (β=2.17, p=0.048) and environment (β=2.69, p=0.006) domains, while females who were separated/divorced (versus single) were inversely associated with psychological health (β=- 2.80, p=0.044) and social relationships domains (β=- 4.33, p=0.011). Females who had Secondary and below education (versus Degree and above) were inversely associated with social relationships (β=- 2.29, p=0.028) and environment domains (β=- 1.79, p=0.048). CONCLUSIONS The findings show the importance of treatments targeting QoL to attend to both the clinical features of the illness as well patient's sociodemographic characteristics.
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Affiliation(s)
- Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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13
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Chang WC, Wong CSM, Or PCF, Chu AOK, Hui CLM, Chan SKW, Lee EMH, Suen YN, Chen EYH. Inter-relationships among psychopathology, premorbid adjustment, cognition and psychosocial functioning in first-episode psychosis: a network analysis approach. Psychol Med 2020; 50:2019-2027. [PMID: 31451127 DOI: 10.1017/s0033291719002113] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Better understanding of interplay among symptoms, cognition and functioning in first-episode psychosis (FEP) is crucial to promoting functional recovery. Network analysis is a promising data-driven approach to elucidating complex interactions among psychopathological variables in psychosis, but has not been applied in FEP. METHOD This study employed network analysis to examine inter-relationships among a wide array of variables encompassing psychopathology, premorbid and onset characteristics, cognition, subjective quality-of-life and psychosocial functioning in 323 adult FEP patients in Hong Kong. Graphical Least Absolute Shrinkage and Selection Operator (LASSO) combined with extended Bayesian information criterion (BIC) model selection was used for network construction. Importance of individual nodes in a generated network was quantified by centrality analyses. RESULTS Our results showed that amotivation played the most central role and had the strongest associations with other variables in the network, as indexed by node strength. Amotivation and diminished expression displayed differential relationships with other nodes, supporting the validity of two-factor negative symptom structure. Psychosocial functioning was most strongly connected with amotivation and was weakly linked to several other variables. Within cognitive domain, digit span demonstrated the highest centrality and was connected with most of the other cognitive variables. Exploratory analysis revealed no significant gender differences in network structure and global strength. CONCLUSION Our results suggest the pivotal role of amotivation in psychopathology network of FEP and indicate its critical association with psychosocial functioning. Further research is required to verify the clinical significance of diminished motivation on functional outcome in the early course of psychotic illness.
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Affiliation(s)
- W C Chang
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - C S M Wong
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - P C F Or
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - A O K Chu
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - C L M Hui
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - S K W Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - E M H Lee
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - E Y H Chen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
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14
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Dong M, Lu L, Zhang L, Zhang YS, Ng CH, Ungvari GS, Li G, Meng X, Wang G, Xiang YT. Quality of Life in Schizophrenia: A Meta-Analysis of Comparative Studies. Psychiatr Q 2019; 90:519-532. [PMID: 31119453 DOI: 10.1007/s11126-019-09633-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Studies and findings regarding the impact of schizophrenia on quality of life (QOL) has been highly variable. This meta-analysis compared QOL between schizophrenia subjects and healthy controls with a focus on standardized measures. A systematic literature search was conducted through Pubmed, PsycINFO, EMBASE, Cochrane Library and Web of Science databases. Only studies using the World Health Organization Quality of Life (WHOQOL) or its brief version or the Short Form-36 Health Survey (SF-36) were included. Fifteen case-control studies with 2195 schizophrenia subjects and 1508 healthy controls were included in this meta-analysis. The WHOQOL/WHOQOL-BREF score was significantly lower in physical health (SMD = -1.80, 95% CI: -2.31 to -1.28, P < 0.001), psychological health (SMD = -1.28, 95% CI: -1.72 to -0.83, P < 0.001), social relationships (SMD = -1.60, 95% CI: -2.05 to -1.15, P < 0.001), and environment domains (SMD = -0.98, 95% CI: -1.38 to -0.59, P < 0.001) in schizophrenia subjects compared to controls. The SF-36 score was significantly lower in both physical (SMD = -1.09, 95% CI: -1.41 to -0.76, P < 0.001 and mental health domains (SMD = -2.08, 95% CI: -3.58 to -0.59, P = 0.006) in schizophrenia subjects than in controls. Subgroup and meta-regression analyses found that age, male gender, illness duration and income have significant moderating effects on QOL. The meta-analysis of studies with standardized measures confirmed that QOL in schizophrenia subjects is significantly lower than healthy controls. Effective interventions should be developed to improve QOL for this population.
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Affiliation(s)
- Min Dong
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Li Lu
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yun-Shu Zhang
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, Hebei Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia, & Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Gang Li
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiangfei Meng
- Department of Psychiatry, McGill University and the Douglas Mental Health University Institute, Montreal, Canada
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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15
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Abstract
UNLABELLED AimsPeople with psychotic disorders face impairments in their global functioning and their quality of life (QoL). The relationship between the two outcomes has not been systematically investigated. Through a systematic review, we aim to explore the presence and extent of associations between global functioning and QoL and establish whether associations depend on the instruments employed. METHODS In May 2016, ten electronic databases were searched using a two-phase process to identify articles in which associations between global functioning and QoL were assessed. Basic descriptive data and correlation coefficients between global functioning and QoL instruments were extracted, with the strength of the correlation assessed according to the specifications of Cohen 1988. Results were reported with reference to the Meta-analysis of Observational Studies in Epidemiology guidelines and PRISMA standards. A narrative synthesis was performed due to heterogeneity in methodological approaches. RESULTS Of an initial 15 183 non-duplicate articles identified, 756 were deemed potentially relevant, with 40 studies encompassing 42 articles included. Fourteen instruments for measuring global functioning and 22 instruments for measuring QoL were used. Twenty-nine articles reported linear associations while 19 assessed QoL predictors. Correlations between overall scores varied in strength, primarily dependent on the QoL instrument employed, and whether QoL was objectively or subjectively assessed. Correlations observed for objective QoL measures were consistently larger than those observed for subjective measures, as were correlations for an interviewer than self-assessed QoL. When correlations were assessed by domains of QoL, the highest correlations were found for social domains of QoL, for which most correlations were moderate or higher. Global functioning consistently predicted overall QoL as did depressive and negative symptoms. CONCLUSIONS This review is the first to explore the extent of associations between global functioning and QoL in people with psychotic disorders. We consistently found a positive association between global functioning and QoL. The strength of the association was dependent on the QoL instrument employed. QoL domains strongly associated with global functioning were highlighted. The review illustrates the extensive array of instruments used for the assessment of QoL and to a lesser extent global functioning in people with psychotic disorders and provides a framework to understand the different findings reported in the literature. The findings can also inform the future choice of instruments by researchers and/or clinicians. The observed associations reassure that interventions for improving global functioning will have a positive impact on the QoL of people living with a psychotic disorder.
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16
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Demetriou EA, Song CY, Park SH, Pepper KL, Naismith SL, Hermens DF, Hickie IB, Thomas EE, Norton A, White D, Guastella AJ. Autism, Early Psychosis, and Social Anxiety Disorder: a transdiagnostic examination of executive function cognitive circuitry and contribution to disability. Transl Psychiatry 2018; 8:200. [PMID: 30250033 PMCID: PMC6155256 DOI: 10.1038/s41398-018-0193-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 02/07/2023] Open
Abstract
The disability burden in clinical cohorts with social impairment is significant, leading to poor functional outcomes. Some of this impairment has been linked to executive dysfunction. In this study, a transdiagnostic approach was taken to identify executive function (EF) processes in young adults that may underpin social impairment and to evaluate their contribution to disability. Comparisons were made between three prominent disorders that are characterized by social impairments, Autism Spectrum Disorder (ASD), Early Psychosis (EP) and Social Anxiety Disorder (SAD), as well as a neurotypically developing group (TYP). We examined whether overall disability could be predicted by neuropsychological and self-report assessments of EF. Our study showed that ASD participants demonstrated impaired performance on most domains of EF compared to the TYP group (mental flexibility, sustained attention and fluency) while the EP group showed impairment on sustained attention and attentional shifting. The SAD participants showed EF impairment on self-report ratings, even though their objective performance was intact. Self-reports of EF explained a significant percentage (17%) of disability in addition to the variance explained by other predictors, and this was particularly important for ASD. This is the first study to compare EF measures across clinical groups of social impairment and suggests unique cognitive-circuitry that underpins disability within groups. Impairments in EF were broad in ASD and predicted disability, EP impairments were specific to attentional processes and SAD impairments likely relate to negative self-monitoring. Self-report, as opposed to performance-based EF, provided best capacity to predict disability. These findings contribute to transdiagnostic circuitry models and intervention strategies.
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Affiliation(s)
- Eleni A. Demetriou
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Christine Y. Song
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Shin H. Park
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Karen L. Pepper
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Sharon L. Naismith
- 0000 0004 1936 834Xgrid.1013.3Youth Mental Health Unit, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia ,0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, 2050 Australia
| | - Daniel F. Hermens
- 0000 0004 1936 834Xgrid.1013.3Youth Mental Health Unit, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Ian B. Hickie
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia ,0000 0004 1936 834Xgrid.1013.3Youth Mental Health Unit, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Emma E. Thomas
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Alice Norton
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Django White
- 0000 0004 1936 834Xgrid.1013.3Youth Mental Health Unit, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
| | - Adam J. Guastella
- 0000 0004 1936 834Xgrid.1013.3Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia ,0000 0004 1936 834Xgrid.1013.3Youth Mental Health Unit, Brain and Mind Centre, Central Clinical School, Faculty of Medicine, University of Sydney, Camperdown, 2050 Australia
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Ohta M, Nakataki M, Takeda T, Numata S, Tominaga T, Kameoka N, Kubo H, Kinoshita M, Matsuura K, Otomo M, Takeichi N, Harada M, Ohmori T. Structural equation modeling approach between salience network dysfunction, depressed mood, and subjective quality of life in schizophrenia: an ICA resting-state fMRI study. Neuropsychiatr Dis Treat 2018; 14:1585-1597. [PMID: 29942132 PMCID: PMC6007191 DOI: 10.2147/ndt.s163132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Quality of life (QOL) is an important clinical outcome for patients with schizophrenia, and recent studies have focused on subjective QOL. We evaluated the causal relationship between psychosocial aspect of subjective QOL, symptoms, cognitive functions, and salience network (SN) dysfunction in schizophrenia using structural equation modeling (SEM). PATIENTS AND METHODS We performed a cross-sectional study of 21 patients with symptomatically stabilized schizophrenia and 21 age-, sex-, and education level-matched healthy controls who underwent resting-state functional magnetic resonance imaging. We evaluated SN dysfunction in schizophrenia using independent component analysis (ICA). We rated participant psychopathology using the Positive and Negative Syndrome Scale (PANSS), the Brief Assessment of Cognition in Schizophrenia (BACS), and the Calgary Depression Scale for Schizophrenia (CDSS). We rated psychosocial aspect of subjective QOL using the Schizophrenia Quality of Life Scale (SQLS) psychosocial subscale. We applied SEM to examine the relationships between SN dysfunction, PANSS positive and negative scores, CDSS total scores, BACS composite scores, and SQLS psychosocial subscale scores. RESULTS In second-level analysis after group ICA, patient group had significant lower right pallidum functional connectivity (FC) within the SN than the controls did (Montreal Neurological Institute [MNI] [x y z] = [22 -2 -6]) (p = 0.027, family-wise error [FWE] corrected). In SEM, we obtained a good fit for an SEM model in which SN dysfunction causes depressed mood, which in turn determines psychosocial aspect of subjective QOL (chi-squared p = 0.9, root mean square error of approximation (RMSEA) < 0.001, comparative fit index [CFI] = 1.00, and standardized root mean square residual [SRMR]= 0.020). CONCLUSION We found a continuous process by which SN dysfunction causes depressed moods that determine psychosocial aspect of subjective QOL in schizophrenia. This is the first report that offers a unified explanation of functional neuroimaging, symptoms, and outcomes. Future studies combining neuroimaging techniques and clinical assessments would elucidate schizophrenia's pathogenesis.
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Affiliation(s)
- Masashi Ohta
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Masahito Nakataki
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tomoya Takeda
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Takeo Tominaga
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Naomi Kameoka
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Hiroko Kubo
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Makoto Kinoshita
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kanae Matsuura
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Maki Otomo
- Department of Radiology and Radiation Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Naoya Takeichi
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology and Radiation Oncology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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18
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Lee SJ, Kim KR, Lee SY, An SK. Impaired Social and Role Function in Ultra-High Risk for Psychosis and First-Episode Schizophrenia: Its Relations with Negative Symptoms. Psychiatry Investig 2017; 14:539-545. [PMID: 29042877 PMCID: PMC5639120 DOI: 10.4306/pi.2017.14.5.539] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Psychosocial dysfunction was a nettlesome problem of schizophrenia even in their prodromal phase as well as in their first-episode. In addition, its relations with psychopathology were not determined. The aim of the present study was to examine whether the social and role function impairment was found in ultra-high risk for psychosis (UHR) individuals as well as first-episode schizophrenia patients and to explore its relations with psychopathology. METHODS Thirty-seven normal controls, 63 UHR participants and 28 young, first-episode schizophrenia patients were recruited. Psychosocial functioning was examined by using Global function: Social and Role scale. Psychopathologies of positive, negative and depressive symptom were also measured. RESULTS Social and role functioning in UHR were compromised at the equivalent level of those of first-episode schizophrenia patients. Multiple linear regression analysis revealed that social and role dysfunction was associated with negative symptoms in each UHR and first-episode schizophrenia group. CONCLUSION These findings suggest that the significant impairment of social and role function may be appeared before the active psychosis onset at the level of extent to those of first-episode schizophrenia patients. The psychosocial intervention strategy especially targeting the negative symptoms should be developed and provided to individuals from their prepsychotic stage of schizophrenia.
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Affiliation(s)
- So Jung Lee
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Kyung Ran Kim
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
- Section of Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Young Lee
- Section of Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
- Section of Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
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19
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Case K, Guo Y, Nixon SJ, Muller K, Huo T, Prather R, Morris H, Stoner D, Shenkman E. Exploring the Role of Executive Functioning Capacity in Patient Activation and Health Outcomes Among Medicaid Members With Multiple Comorbidities. Med Care Res Rev 2017; 76:444-461. [DOI: 10.1177/1077558717709419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient activation, the perceived capacity to manage one’s health, is positively associated with better health outcomes and lower costs. Underlying characteristics influencing patient activation are not completely understood leading to gaps in intervention strategies designed to improve patient activation. We suggest that variability in executive functioning influences patient activation and ultimately has an impact on health outcomes. To examine this hypothesis, 440 chronically ill Medicaid enrollees completed measures of executive functioning, patient activation, and health-related quality of life. Mediation analyses revealed that executive functioning: (a) directly affected patient activation and mental health-related quality of life, (b) indirectly affected mental health-related quality of life through patient activation, and (c) was unrelated to physical health-related quality of life. These data indicate that further study of the relationships among neurocognitive processes, patient activation, and health-related quality of life is needed and reinforces previous work demonstrating the association between patient activation and self-reported outcomes.
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Affiliation(s)
| | - Yi Guo
- University of Florida, Gainesville, FL, USA
| | | | | | | | | | | | - Dena Stoner
- Department of State Health Services, Austin, TX, USA
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20
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Lee SJ, Kim KR, Lee SY, An SK. Impaired Social and Role Function in Ultra-High Risk for Psychosis and First-Episode Schizophrenia: Its Relations with Negative Symptoms. Psychiatry Investig 2017; 14:186-192. [PMID: 28326117 PMCID: PMC5355017 DOI: 10.4306/pi.2017.14.2.186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Psychosocial dysfunction was a nettlesome of schizophrenia even in their prodromal phase as well as first episode and its relations with psychopathology were not determined. The aim of the present study was to examine whether the social and role function impairment was found in ultra-high risk for psychosis (UHR) individuals as well as first-episode schizophrenia patients and to explore its relations with psychopathology. METHODS Thirty-seven normal controls, 63 UHR participants and 28 young, first-episode schizophrenia patients were recruited. Psychosocial functioning was examined by using Global function: Social and Role scale. Psychopathologies of positive, negative and depressive symptom were also measured. RESULTS Social and role functioning in UHR were compromised at the equivalent level of those of first-episode schizophrenia patients. Multiple linear regression analysis revealed that social and role dysfunction was associated with negative symptoms in each UHR and first-episode schizophrenia group. CONCLUSION These findings suggest that the significant impairment of social and role function may be appeared before the active psychosis onset at the level of extent to those of first-episode schizophrenia patients. The psychosocial intervention strategy especially targeting the negative symptoms should be developed and provided to individuals from their prepsychotic stage of schizophrenia.
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Affiliation(s)
- So Jung Lee
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Kyung Ran Kim
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Young Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
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21
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Glenthøj LB, Jepsen JRM, Hjorthøj C, Bak N, Kristensen TD, Wenneberg C, Krakauer K, Nordentoft M, Fagerlund B. Negative symptoms mediate the relationship between neurocognition and function in individuals at ultrahigh risk for psychosis. Acta Psychiatr Scand 2017; 135:250-258. [PMID: 27988937 DOI: 10.1111/acps.12682] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Neurocognition is known to impact functioning in individuals at ultrahigh risk (UHR) for psychosis, but studies investigating potential mediators of this relationship are scarce. Building on evidence from schizophrenia spectrum disorders, the study tested whether negative symptoms and social skills act as mediators between neurocognition and functional outcome in UHR individuals. METHODS Ultrahigh risk participants (N = 84) underwent neurocognitive testing using the Brief Assessment of Cognition in Schizophrenia. Social skills and negative symptoms were assessed using the High-Risk Social Challenge task and the Scale for the Assessment of Negative Symptoms respectively. Four instruments were used to assess overall functioning, and one instrument assessed quality of life encompassing social functioning. RESULTS The cross-sectional analyses revealed that neurocognition was related to the measures of functioning. Negative symptoms mediated the relationship between neurocognition and four of the five measures of functioning. We did not find social skills to mediate between neurocognition and functioning. CONCLUSION Negative symptoms appear to mediate the relationship between neurocognition and functional outcome in UHR individuals, but the finding needs to be confirmed and extended to longitudinal studies. This underscores the importance of focusing on both neurocognition and negative symptoms when aiming at improving the functional outcome of UHR individuals.
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Affiliation(s)
- L B Glenthøj
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark
| | - J R M Jepsen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.,Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - C Hjorthøj
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - N Bak
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.,Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - T D Kristensen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark
| | - C Wenneberg
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.,Functional Imaging Unit, Department of Diagnostics, Copenhagen University Hospital, Glostrup, Denmark
| | - K Krakauer
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.,Functional Imaging Unit, Department of Diagnostics, Copenhagen University Hospital, Glostrup, Denmark
| | - M Nordentoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark
| | - B Fagerlund
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.,Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
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22
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Takeuchi H, Fervaha G, Remington G. Reliability of a patient-reported outcome measure in schizophrenia: Results from back-to-back self-ratings. Psychiatry Res 2016; 244:415-9. [PMID: 27543916 DOI: 10.1016/j.psychres.2016.07.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/28/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
This study aimed to assess patient's capacity to perform a patient-reported outcome (PRO) measure (i.e., a self-rating scale) and examine its relationship with clinical characteristics including cognition. Fifty patients with schizophrenia were asked to rate the Subjective Well-being under Neuroleptics scale - Short form (SWNS) twice; the second rating was started immediately after they completed the first to minimize the gap between ratings. At the same time, the Positive and Negative Symptoms Scale (PANSS) and Brief Neurocognitive Assessment (BNA) were administered. The correlations between the two ratings for the SWNS total and each item scores were high (rs=0.94 and rs=0.60-0.84, respectively); however, for 16 (80%) of 20 items, 5 or more patients (i.e., ≥10%) demonstrated a>1 point score difference. There was no significant correlation between the SWNS total score difference and any clinical characteristics including age, education duration, illness duration, antipsychotic dose, psychopathology, and cognition. In contrast, the number of items with a>1 point score difference was significantly correlated with disorganized symptoms and overall severity (rs=0.29 for both), as well as working memory and global cognition (rs=-0.41 and rs=-0.40, respectively). These findings suggest that PROs should be interpreted with caution in patients with schizophrenia with prominent disorganization and cognitive impairment.
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Affiliation(s)
- Hiroyoshi Takeuchi
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| | - Gagan Fervaha
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Gary Remington
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
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23
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Kung WW. Culture- and Immigration-Related Stress Faced by Chinese American Families with a Patient Having Schizophrenia. JOURNAL OF MARITAL AND FAMILY THERAPY 2016; 42:409-422. [PMID: 27388227 DOI: 10.1111/jmft.12145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The impact of culture and immigration on the experience of Chinese American families with a member having schizophrenia is explored within the frameworks of family systems and stress and coping. This qualitative study was conducted within an intervention study of family psychoeducation using therapists' session notes from 103 family sessions and 13 relatives' group sessions from nine patients and 19 relatives. The high stigma attached to mental illness leading to social isolation, and families' devotion to caregiving exacerbated caregiver burden. Taboo against discussing dating and sexuality and the consideration of arranged marriages caused unique stress. The insecurity as immigrants and shortage of bilingual services were related to greater enmeshment within these families. Implications on research methodology and practice are discussed.
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24
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Dauwan M, Begemann MJH, Heringa SM, Sommer IE. Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis. Schizophr Bull 2016; 42:588-99. [PMID: 26547223 PMCID: PMC4838091 DOI: 10.1093/schbul/sbv164] [Citation(s) in RCA: 224] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Physical exercise may be valuable for patients with schizophrenia spectrum disorders as it may have beneficial effect on clinical symptoms, quality of life and cognition. METHODS A systematic search was performed using PubMed (Medline), Embase, PsychInfo, and Cochrane Database of Systematic Reviews. Controlled and uncontrolled studies investigating the effect of any type of physical exercise interventions in schizophrenia spectrum disorders were included. Outcome measures were clinical symptoms, quality of life, global functioning, depression or cognition. Meta-analyses were performed using Comprehensive Meta-Analysis software. A random effects model was used to compute overall weighted effect sizes in Hedges' g. RESULTS Twenty-nine studies were included, examining 1109 patients. Exercise was superior to control conditions in improving total symptom severity (k = 14, n = 719: Hedges' g = .39, P < .001), positive (k = 15, n = 715: Hedges' g = .32, P < .01), negative (k = 18, n = 854: Hedges' g = .49, P < .001), and general (k = 10, n = 475: Hedges' g = .27, P < .05) symptoms, quality of life (k = 11, n = 770: Hedges' g = .55, P < .001), global functioning (k = 5, n = 342: Hedges' g = .32, P < .01), and depressive symptoms (k = 7, n = 337: Hedges' g = .71, P < .001). Yoga, specifically, improved the cognitive subdomain long-term memory (k = 2, n = 184: Hedges' g = .32, P < .05), while exercise in general or in any other form had no effect on cognition. CONCLUSION Physical exercise is a robust add-on treatment for improving clinical symptoms, quality of life, global functioning, and depressive symptoms in patients with schizophrenia. The effect on cognition is not demonstrated, but may be present for yoga.
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Affiliation(s)
- Meenakshi Dauwan
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus, VU University Medical Center, Amsterdam, The Netherlands
| | - Marieke J H Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sophie M Heringa
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris E Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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25
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Fujino H, Sumiyoshi C, Sumiyoshi T, Yasuda Y, Yamamori H, Ohi K, Fujimoto M, Hashimoto R, Takeda M, Imura O. Predicting employment status and subjective quality of life in patients with schizophrenia. Schizophr Res Cogn 2016; 3:20-25. [PMID: 28740804 PMCID: PMC5506698 DOI: 10.1016/j.scog.2015.10.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/09/2015] [Accepted: 10/15/2015] [Indexed: 11/16/2022]
Abstract
Although impaired social functioning, particularly poor employment status, is a cardinal feature of patients with schizophrenia and leads to decreased quality of life (QOL), few studies have addressed the relationship between these two clinical issues. The aim of this study was to determine whether employment status predicts subjective QOL and to evaluate a model in which functional capacity mediates the relationship between general cognitive performance and employment status. Ninety-three patients with schizophrenia were administered a comprehensive battery of cognitive tests, the UCSD Performance-based Skills Assessment-Brief version (UPSA-B), the Social Functioning Scale (SFS), and the Subjective Quality of Life Scale (SQLS). First, we evaluated a model for predicting the employment/occupation subscale score of the SFS using path analysis, and the model fitted well (χ2 (4) = 3.6, p = 0.46; CFI = 1.0; RMSEA < 0.001, with 90% CIs: 0-0.152). Employment status was predicted by negative symptoms and functional capacity, which was in turn predicted by general cognitive performance. Second, we added subjective QOL to this model. In a final path model, QOL was predicted by negative symptoms and employment status. This model also satisfied good fit criteria (χ2 (7) = 10.3, p = 0.17; CFI = 0.987; RMSEA = 0.072, with 90% CIs: 0-0.159). The UPSA-B and SFS scores were moderately correlated with most measures of cognitive performance. These results support the notion that better employment status enhances subjective QOL in patients with schizophrenia.
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Affiliation(s)
- Haruo Fujino
- Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, 1 Kanayagawa, Fukushima, Fukushima 960-1296, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashimachi, Kodaira, Tokyo 187-8551, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Osaka University Graduate School of Medicine, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masatoshi Takeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, D3, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Uwatoko T, Yoshizumi M, Miyata J, Ubukata S, Fujiwara H, Kawada R, Kubota M, Sasamoto A, Sugihara G, Aso T, Urayama S, Fukuyama H, Murai T, Takahashi H. Insular Gray Matter Volume and Objective Quality of Life in Schizophrenia. PLoS One 2015; 10:e0142018. [PMID: 26544607 PMCID: PMC4636237 DOI: 10.1371/journal.pone.0142018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/15/2015] [Indexed: 12/21/2022] Open
Abstract
Improving quality of life has been recognized as an important outcome for schizophrenia treatment, although the fundamental determinants are not well understood. In this study, we investigated the association between brain structural abnormalities and objective quality of life in schizophrenia patients. Thirty-three schizophrenia patients and 42 age-, sex-, and education-matched healthy participants underwent magnetic resonance imaging. The Quality of Life Scale was used to measure objective quality of life in schizophrenia patients. Voxel-based morphometry was performed to identify regional brain alterations that correlate with Quality of Life Scale score in the patient group. Schizophrenia patients showed gray matter reductions in the frontal, temporal, limbic, and subcortical regions. We then performed voxel-based multiple regression analysis in these regions to identify any correlations between regional gray matter volume and Quality of Life Scale scores. We found that among four subcategories of the scale, the Instrumental Role category score correlated with gray matter volume in the right anterior insula in schizophrenia patients. In addition, this correlation was shown to be mediated by negative symptoms. Our findings suggest that the neural basis of objective quality of life might differ topographically from that of subjective QOL in schizophrenia.
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Affiliation(s)
- Teruhisa Uwatoko
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Kyoto University Health Service, Kyoto, Japan
| | - Miho Yoshizumi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shiho Ubukata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hironobu Fujiwara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Kyoto University Hospital Integrated Clinical Education Center, Kyoto, Japan
| | - Ryosaku Kawada
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Manabu Kubota
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Akihiko Sasamoto
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshihiko Aso
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Urayama
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Sum MY, Ho NF, Sim K. Cross diagnostic comparisons of quality of life deficits in remitted and unremitted patients with schizophrenia and bipolar disorder. Schizophr Res 2015; 168:191-6. [PMID: 26341581 DOI: 10.1016/j.schres.2015.08.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/19/2015] [Accepted: 08/21/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with schizophrenia (SCZ) and bipolar disorder (BD) have been found to report lower quality of life (QOL) compared to healthy controls separately. However, data are wanting on cross diagnostic comparisons of QOL within psychotic spectrum conditions. This study examined QOL differences and clinical predictors between schizophrenia (SCZ) and bipolar disorder (BD). Based on extant data, we hypothesized that patients with remitted SCZ and BD had comparable QOL levels, and that more severe symptoms and poorer psychosocial functioning predicted poorer QOL in our patients. METHODS Two hundred and twenty-two sex and age-matched subjects (44 BD, 122 SCZ, 56 healthy controls) were assessed on their QOL, psychosocial functioning, symptomatology, and state of remission. RESULTS Overall, SCZ patients had worse QOL in the environment domain (p=0.008) and overall QOL (p=0.007) compared with BD patients. Both patient groups in remission had similar QOL, while unremitted SCZ patients reported poorer QOL in all domains compared to unremitted BD patients (p<0.01). Within patients, greater severity of negative symptoms and poorer psychosocial functioning were associated with poorer QOL (p<0.05). DISCUSSION Remission status affected QOL in both patient groups. The association of worse QOL with greater negative psychotic psychopathology and poorer psychosocial functioning highlighted potential clinical markers of QOL, which can aid in the management of psychotic spectrum disorders.
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Affiliation(s)
- Min Yi Sum
- Research Division, Institute of Mental Health, Singapore
| | - New Fei Ho
- Research Division, Institute of Mental Health, Singapore
| | - Kang Sim
- Research Division, Institute of Mental Health, Singapore; Department of General Psychiatry, Institute of Mental Health, Singapore.
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Abstract
PURPOSE The study reported here aimed to evaluate both biological and psychosocial factors as predictors for quality of life as well as to examine the associations between the factors and quality of life in individuals with schizophrenia. METHODS Eighty individuals with schizophrenia were recruited to the study. The Thai version of the World Health Organization Quality of Life-BREF was utilized to measure the quality of life. The five Marder subscales of the Positive and Negative Syndrome Scale were applied. Other tools for measurement included the Calgary Depression Scale for Schizophrenia and six social support deficits (SSDs). Pearson/Spearman correlation coefficients and the independent t-test were used for the statistical analysis to determine the associations of variables and the overall quality of life and the four domain scores. A multiple linear regression analysis of the overall quality of life and four domain scores was applied to determine their predictors. RESULTS The Positive and Negative Syndrome Scale total score, positive symptoms, negative symptoms, disorganized thought, and anxiety/depression showed a significant correlation with the overall quality of life and most of the four domain scores. Depression, SSDs, and adverse drug events showed a significant correlation with a poorer overall quality of life. The multiple linear regression model revealed that negative symptoms, depression, and seeing a relative less often than once per week were predictors for the overall quality of life (adjusted R (2)=0.472). Negative symptoms were also found to be the main factors predicting a decrease in the four domains of quality of life - physical health, psychological, social relationships, and environment. CONCLUSION Negative symptoms, depression, and poor contact with relatives were the foremost predictors of poor quality of life in individuals with schizophrenia. Positive symptoms, negative symptoms, disorganized thought, anxiety/depression, SSDs, and adverse events were also found to be correlated with quality of life.
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Affiliation(s)
- Sirijit Suttajit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sutrak Pilakanta
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Bai YM, Hsiao CY, Chen KC, Huang KL, Lee IH, Hsu JW, Chen PS, Yang YK. The development of a self-reported scale for measuring functionality in patients with schizophrenia--self-reported version of the graphic Personal and Social Performance (SRG-PSP) scale. Schizophr Res 2014; 159:546-51. [PMID: 25257944 DOI: 10.1016/j.schres.2014.08.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 08/11/2014] [Accepted: 08/15/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND The Personal and Social Performance (PSP) scale is used for the assessment of patient function by mental health professionals. This study aimed to evaluate the internal reliability and validity of a self-reported graphic version of the PSP (SRG-PSP) scale and its correlations with psychiatric symptoms, daily life ability and quality of life. METHODS The SRG-PSP scale was developed following the four PSP domains: socially useful activities, personal and social relationships, self-care, and disturbing and aggressive behavior. In total, 108 patients with schizophrenia were enrolled. All participants completed the SRG-PSP, the Activities of Daily Living Rating Scale II (ADLRS-II), and the World Health Organization Quality of Life-BREF (WHOQOL). They were also assessed using the PSP and the Positive and Negative Syndrome Scale (PANSS). Spearman's ρ was used to examine the correlations between SRG-PSP scores and other variables. RESULTS The results of the SRG-PSP were significantly correlated to those of their corresponding criteria on the PSP. The global score of the SRG-PSP and the scores of three domains, socially useful activities, personal and social relationships, and self-care, were positively correlated with most sub items of the ADLRS-II and WHOQOL, and were negatively correlated with the PANSS scores. The disturbing and aggressive behavior domain of the SRG-PSP was negatively correlated with most sub items of the ADLRS-II and WHOQOL (ρ=-0.19 to -0.36, all p<0.05) and positively correlated with the PANSS (ρ=0.24-0.30, all p<0.05), with the exception of negative symptoms (ρ=0.09, p=0.40). CONCLUSION The SRG-PSP is a valid self-reported scale for the assessment of functionality in patients with schizophrenia.
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Affiliation(s)
- Ya Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih Yin Hsiao
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan.
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Jelastopulu E, Giourou E, Merekoulias G, Mestousi A, Moratis E, Alexopoulos EC. Correlation between the Personal and Social Performance scale (PSP) and the Positive and Negative Syndrome Scale (PANSS) in a Greek sample of patients with schizophrenia. BMC Psychiatry 2014; 14:197. [PMID: 25005616 PMCID: PMC4227001 DOI: 10.1186/1471-244x-14-197] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 06/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychosocial dysfunction is one of schizophrenia's core features, often leading to a deprecation of independent living and significant failure to maintain a competent quality of life. Cognitive and occupational performance as well as psychosocial functioning is moreover recognized as determinants of treatment response. Therefore, the elaboration of measures regarding social performance besides scales that assess psychopathology is essential. The Personal and Social Performance (PSP) scale has been found to be as much valid as reliable for assessing social functioning in the acute and stable stage of schizophrenia. The aim of this study was to estimate the correlation between the PSP and Positive and Negative Syndrome Scale (PANSS) (convergent validity) in patients with schizophrenia during routine clinical practice. METHODS A longitudinal study with a six-month follow-up is presented. Correlation between the PSP scale and the Positive and Negative Syndrome Scale (PANSS) was conducted in a Greek sample of 2010 patients with schizophrenia in outpatient setting in two successive visits. PANSS and PSP scales were used for the assessment of psychopathological symptoms and social and personal functioning. RESULTS The PSP subscales scores were well correlated with each other with Spearman correlation coefficients (r) ranging from 0.56 to 0.76 on both visits in three out of the four main areas, whereas in the category of "disturbing and aggressive behavior" the correlations were lower but still significant. Furthermore, total PSP score showed high association to PANSS total score in the first (r = -0.59) as well as in the second visit (r = -0.50). Regression analysis showed that one point decrease of PANSS's total score is associated with a 0.42 points increase on the PSP scale. PSP and PANSS scales exhibited high convergent validity. CONCLUSIONS The PSP could provide additional valuable information in the assessment of schizophrenia related social functioning and treatment response.
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Affiliation(s)
- Eleni Jelastopulu
- Department of Public Health, School of Medicine, University of Patras, Rio-Patras GR-26500, Greece.
| | - Evangelia Giourou
- Department of Public Health, School of Medicine, University of Patras, Rio-Patras GR-26500, Greece
| | - Giorgos Merekoulias
- Department of Public Health, School of Medicine, University of Patras, Rio-Patras GR-26500, Greece
| | | | | | - Evangelos C Alexopoulos
- Department of Public Health, School of Medicine, University of Patras, Rio-Patras GR-26500, Greece
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Ogino S, Miyamoto S, Miyake N, Yamaguchi N. Benefits and limits of anticholinergic use in schizophrenia: focusing on its effect on cognitive function. Psychiatry Clin Neurosci 2014; 68:37-49. [PMID: 24102938 DOI: 10.1111/pcn.12088] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 04/25/2013] [Accepted: 05/26/2013] [Indexed: 12/17/2022]
Abstract
All currently available antipsychotic drugs are the dopamine D2 receptor antagonists and are capable of producing extrapyramidal side-effects (EPS). Anticholinergic drugs are primarily used to treat EPS or prevent EPS induced by antipsychotics in the treatment of psychosis and schizophrenia. However, they can cause a variety of distressing peripheral side-effects (e.g. dry mouth, urinary disturbances, and constipation) and central adverse effects (e.g. cognitive impairment, worsening of tardive dyskinesia, and delirium). Disturbances in cognitive abilities are cardinal features of schizophrenia from its earliest phases and account for much of the functional disability associated with the illness. It is likely that long-term concomitant administration of anticholinergics exacerbates the underlying cognitive impairment in patients with schizophrenia and subsequently affects patients' quality of life. Thus, current treatment guidelines for schizophrenia generally do not recommend the prophylactic and long-term use of anticholinergics. However, the high use of long-term anticholinergic drugs with antipsychotics has been identified as an important issue in the treatment of schizophrenia in several countries. To assess the benefits and limits of anticholinergic use in psychosis and schizophrenia, this article will provide a brief review of the pharmacology and clinical profiles of anticholinergic drugs and will focus on their effects on cognitive function in schizophrenia, particularly during the course of the early phase of the illness. In addition, we will address the effects of discontinuation of anticholinergics on cognitive function in patients with schizophrenia and provide a strategy for adjunctive anticholinergic use in patients treated with long-acting injectable antipsychotics.
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Affiliation(s)
- Shin Ogino
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kanagawa, Japan
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Lin CH, Huang CL, Chang YC, Chen PW, Lin CY, Tsai GE, Lane HY. Clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia. Schizophr Res 2013; 146:231-7. [PMID: 23478155 DOI: 10.1016/j.schres.2013.02.009] [Citation(s) in RCA: 147] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 01/22/2013] [Accepted: 02/06/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND The functional outcome of schizophrenia is affected by multiple factors such as cognitive function and clinical symptoms. The complex relationship among cognitive function (both neuro- and social-cognitions), clinical symptoms, and functional outcome remains unclear. The current study employed structural equation modeling (SEM) to examine whether clinical symptoms mediate the relationship between cognitive function and functional outcome in a large cohort of patients with schizophrenia. METHOD Three hundred and two Han-Chinese patients with chronically stable schizophrenia received evaluation of cognitive function (using the Measurement and Treatment Research to Improve Cognition in Schizophrenia [MATRICS] Consensus Cognitive Battery, including 7 domains covering neurocognition and social cognition), clinical symptoms (including positive, negative and depressive symptoms), and functional outcome as assessed by Global Assessment of Functioning Scale and Quality of Life Scale. RESULTS SEM identified clinical symptoms as a mediator between cognitive function (including all 7 domains of MATRICS) and functional outcome in schizophrenia. The relationship between cognitive function and functional outcome was significant in the basic model. In the mediation model, the link between cognitive function and functional outcome was mediated by clinical symptoms, mainly negative symptoms. CONCLUSION This study suggests that clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia. Future studies should explore the impact on other functional outcomes in different ethnicities and various illness phases.
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Affiliation(s)
- Chieh-Hsin Lin
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Tanaka T, Tomotake M, Ueoka Y, Kaneda Y, Taniguchi K, Nakataki M, Numata S, Tayoshi S, Yamauchi K, Sumitani S, Ohmori T, Ueno SI, Ohmori T. Clinical correlates associated with cognitive dysfunction in people with schizophrenia. Psychiatry Clin Neurosci 2012; 66:491-8. [PMID: 23066766 DOI: 10.1111/j.1440-1819.2012.02390.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIMS The purpose of the present study was to investigate the correlation between cognitive function and clinical variables in people with schizophrenia. METHODS The subjects were 61 stabilized outpatients with schizophrenia (DSM-IV). Their mean age was 40.1 (SD = 12.2) years. All subjects gave written informed consent to participate in the research. Cognitive function was evaluated using the Brief Assessment of Cognition in Schizophrenia. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, and the Drug-Induced Extrapyramidal Symptoms Scale. RESULTS The Positive and Negative Syndrome Scale Negative syndrome score was significantly correlated with verbal memory score (r = -0.37, P < 0.01), working memory score (r = 0.38, P < 0.01), attention and speed of information processing score (r = -0.51, P < 0.01), verbal fluency score (r = -0.39, P < 0.01), and composite score (r = -0.54, P < 0.01). In addition, the Drug-Induced Extrapyramidal Symptoms Scale score was significantly correlated with attention and speed of information processing (r = -0.45, P < 0.01), and composite score (r = -0.41, P < 0. 01). Dose of antipsychotics and anti-Parkinson drugs was not significantly correlated with the Brief Assessment of Cognition in Schizophrenia scores. CONCLUSIONS These results indicate that cognitive dysfunction of people with schizophrenia might be associated with negative and drug-induced extrapyramidal symptoms, suggesting that their minimization would be important for improving cognitive dysfunction.
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Affiliation(s)
- Tsunehiko Tanaka
- Department of Psychiatry, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
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Boyer L, Aghababian V, Richieri R, Loundou A, Padovani R, Simeoni MC, Auquier P, Lançon C. Insight into illness, neurocognition and quality of life in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36:271-6. [PMID: 22019603 DOI: 10.1016/j.pnpbp.2011.10.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 10/06/2011] [Accepted: 10/10/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess the impact of insight into illness on self-reported quality of life (QoL) for patients with schizophrenia. METHODS This cross-sectional study was conducted in the psychiatric department of a French public university teaching hospital. The data collected included socio-demographic information, clinical characteristics, medications, cognitive performance assessments, insight into illness, and the S-QoL 18. A multivariate analysis using multiple linear regressions was performed to determine variables potentially associated with QoL levels. RESULTS One hundred and thirteen outpatients with stable schizophrenia were enrolled in our study. Significant associations were found between QoL and socio-demographic characteristics: a higher QoL was associated with marital status (in couple) and employment. Concerning insight into illness, lower QoL levels were associated with better awareness of the mental disorder, whereas higher QoL levels were associated with better awareness of positive and negative symptoms. Elementary neuropsychological measures were not statistically associated with QoL. CONCLUSION Insight into illness, marital status and employment were the most important features associated with QoL, whereas there was no evidence that elementary neurocognition directly influenced QoL. The different facets of insight into illness should be considered to guide the development of specific interventions intended to improve QoL. Moreover, this study highlights the need for clinicians to pay more attention to the personal impact of schizophrenia, especially upon family life and work.
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Affiliation(s)
- L Boyer
- Aix-Marseille Univ, EA 3279 Research Unit, 13385 Marseille, France.
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Kitajima R, Miyamoto S, Tenjin T, Ojima K, Ogino S, Miyake N, Fujiwara K, Funamoto Y, Arai J, Tsukahara S, Ito Y, Tadokoro M, Anai K, Kaneda Y, Yamaguchi N. Effects of tapering of long-term benzodiazepines on cognitive function in patients with schizophrenia receiving a second-generation antipsychotic. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36:300-6. [PMID: 22122880 DOI: 10.1016/j.pnpbp.2011.11.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 11/12/2011] [Accepted: 11/14/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND The high use of long-term benzodiazepines (BZDs) with second-generation antipsychotics (SGAs) has been identified as an important issue in the treatment of schizophrenia in Japan. The aim of this study was to evaluate the effects of gradual reduction or discontinuation of daytime BZD use on cognitive function and quality of life (QOL) in patients with chronic schizophrenia receiving an SGA. METHODS Thirty schizophrenic patients who had received an SGA with concomitant BZDs for at least 3 months were enrolled. Before and 4 weeks after tapering of daytime BZDs, the Brief Assessment of Cognition in Schizophrenia Japanese-language version (BACS-J) and the Schizophrenia Quality of Life Scale Japanese-language version (SQLS-J) were administered. Clinical evaluation also included the Positive and Negative Syndrome Scale (PANSS). To compare for practice effects on the BACS-J, 10 patients with chronic schizophrenia were assessed without tapering BZDs. RESULTS BZDs were reduced or discontinued safely in most patients, and no emergent withdrawal symptoms were observed. Significant improvements were shown in verbal memory, working memory, and composite score, as measured by the BACS-J without practice effects. In addition, the motivation/energy score on the SQLS-J, the negative symptoms and total scores on the PANSS significantly improved after tapering BZDs. CONCLUSION Reduction or discontinuation of long-term daytime use of BZDs may be warranted in patients with schizophrenia treated with SGAs, as it may improve cognitive function, subjective QOL, and psychiatric symptoms with no significant adverse effects.
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Affiliation(s)
- Rei Kitajima
- Department of Neuropsychiatry, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
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Tenjin T, Miyamoto S, Miyake N, Ogino S, Kitajima R, Ojima K, Arai J, Teramoto H, Tsukahara S, Ito Y, Tadokoro M, Anai K, Funamoto Y, Kaneda Y, Sumiyoshi T, Yamaguchi N. Effect of blonanserin on cognitive function in antipsychotic-naïve first-episode schizophrenia. Hum Psychopharmacol 2012; 27:90-100. [PMID: 22278973 DOI: 10.1002/hup.1276] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effects of blonanserin, a novel antipsychotic, on cognitive function in first-episode schizophrenia. METHODS Twenty-four antipsychotic-naïve patients with first-episode schizophrenia participated in the study. Blonanserin was given in an open-label design for 8 weeks. The Brief Assessment of Cognition in Schizophrenia-Japanese language version (BACS-J) was administered as the primary outcome measure at baseline and 8 weeks. Clinical evaluation included the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Quality of Life Scale-Japanese language version (SQLS-J), and the Clinical Global Impression-Severity of Illness Scale (CGI-S). To exclude the possibility of retest effects on the BACS-J, 10 age-matched patients with chronic schizophrenia treated with blonanserin were tested at baseline and after an 8-week interval. RESULTS Twenty first-episode patients completed the study. Repeated measures analysis of covariance revealed a significant group-by-time interaction effect on the letter fluency task due to better performance in the first-episode group, but not in the control group. Main effect of time or group-by-time interaction effect on the Tower of London task was not significant; however, the first-episode group, but not the control group, showed substantial improvement with a moderate effect size. All items on the PANSS, SQLS-J, and CGI-S significantly improved after 8 weeks of treatment. CONCLUSIONS These results suggest that blonanserin improves some types of cognitive function associated with prefrontal cortical function.
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Affiliation(s)
- Tomomi Tenjin
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
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Jenaro C, Cruz M, Perez MDC, Flores NE, Vega V. Utilization of the supports intensity scale with psychiatric populations: psychometric properties and utility for service delivery planning. Arch Psychiatr Nurs 2011; 25:e9-17. [PMID: 21978811 DOI: 10.1016/j.apnu.2011.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 05/15/2011] [Accepted: 05/18/2011] [Indexed: 11/28/2022]
Abstract
In agreement with the new paradigm of supports, this study examines the adequacy and psychometric properties of the Supports Intensity Scale (SIS) in a sample of 182 participants with severe mental illness (mean Global Assessment of Functioning [GAF] score = 60.2). The measure focuses on identifying the profile and intensities of support needs and on the planning and service delivery rather than on weaknesses and limitations. Internal consistency indexes ranged from .83 to .97; interrater reliability indexes ranged from .67 to .98. Intercorrelations among SIS subscales supported its construct validity. SIS scores correlated to GAF scores and length of disease. Discriminant analysis correctly classified 60.9% of participants. Therefore, the SIS demonstrated adequate reliability and validity, and it can be used by nursing professionals to plan for required supports in this population.
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Affiliation(s)
- Cristina Jenaro
- Instituto Universitario de Integración en Comunidad (INICO), Facultad de Psicología, Depto. de Personalidad Evaluación y Tratamiento Psicológicos, Avda. de Merced, 109-131, 37005-Salamanca, Spain.
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Song YY, Kim KR, Park JY, Lee SY, Kang JI, Lee E, An SK, Kwon JS. Associated factors of quality of life in first-episode schizophrenia patients. Psychiatry Investig 2011; 8:201-6. [PMID: 21994506 PMCID: PMC3182384 DOI: 10.4306/pi.2011.8.3.201] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Revised: 06/22/2011] [Accepted: 07/07/2011] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Improving quality of life is an important goal in the treatment of schizophrenia. In previous research, quality of life has been reported to be compromised in patients with schizophrenia. The aim of this study was to investigate whether quality of life may be impaired in first-episode schizophrenia patients and to identify the associated factors of quality of life in first-episode schizophrenia. METHODS Forty-eight patients with first-episode schizophrenia and 20 normal controls were recruited. Quality of life was measured by using the Quality of Life scale (QLS). General and social self-efficacy, perceived social support were measured by using the self-report scales. The clinical assessments and comprehensive neurocognitive battery were also administered. RESULTS First-episode group showed significantly decreased QLS total and QLS subscale scores compared to normal controls group. The key associated factors of quality of life in patients with first-episode schizophrenia were the negative symptoms and social self-efficacy. CONCLUSION This finding implies that compromised quality of life may be already emerged in schizophrenia in their first-episode and the psychosocial interventions should be targeting the negative symptoms and the psychosocial protective factors including self-efficacy in addition to simply ameliorating the positive symptoms to foster social reintegration and recovery of first-episode patients.
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Affiliation(s)
- Yun Young Song
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Ran Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Young Park
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Su Young Lee
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Jee In Kang
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Ilsan Hospital, National Health Insurance Corporation, Goyang, Korea
| | - Eun Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
- Section of Affect and Neuroscience, Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Saxena S, Ayers CR, Maidment KM, Vapnik T, Wetherell JL, Bystritsky A. Quality of life and functional impairment in compulsive hoarding. J Psychiatr Res 2011; 45:475-80. [PMID: 20822778 PMCID: PMC3009837 DOI: 10.1016/j.jpsychires.2010.08.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Revised: 08/03/2010] [Accepted: 08/10/2010] [Indexed: 11/21/2022]
Abstract
Compulsive hoarding patients have been found in previous studies to have substantial disability and functional impairment. However, no prior study has examined subjective and objective quality of life (QOL) in patients with compulsive hoarding. This present study compared compulsive hoarders and non-hoarding OCD patients across a variety of QOL domains. Subjects were 171 consecutive adult patients (34 compulsive hoarders, 137 non-hoarding patients with DSM-IV OCD) treated openly between 1998 and 2004 in the UCLA OCD Partial Hospitalization Program (OCD PHP), a specialized, intensive, multi-modal treatment program for treatment-refractory patients. Scores on the Quality of Life Scale and other symptom severity measures on admission were compared between compulsive hoarders and non-hoarding OCD patients. Compulsive hoarders were older and had lower global functioning than non-hoarding OCD patients. Both groups had low overall QOL scores across multiple domains. Compulsive hoarders had significantly lower levels of satisfaction with their safety than non-hoarding OCD patients, were more often the victims of both violent and non-violent crime, felt less safe in their neighborhoods, and felt less protected against attack. Compulsive hoarders were also much less satisfied with their living arrangements than non-hoarding OCD patients. No differences were found on financial variables, but the vast majority of patients in both groups were unemployed. Compulsive hoarders have lower QOL than non-hoarding OCD patients in the domains of safety and living situation. Psychosocial rehabilitation that focuses on problems with victimization, safety, employment, and financial areas may be a beneficial augmentation to treatment for compulsive hoarding.
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Affiliation(s)
- Sanjaya Saxena
- Department of Psychiatry, University of California at San Diego, 140 Arbor Drive, San Diego, CA 92103, United States.
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Mas-Expósito L, Amador-Campos JA, Gómez-Benito J, Lalucat-Jo L. The World Health Organization Quality of Life Scale Brief Version: a validation study in patients with schizophrenia. Qual Life Res 2011; 20:1079-89. [PMID: 21290191 DOI: 10.1007/s11136-011-9847-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) is used for patients with schizophrenia although no validation is available. This work addresses this issue by dealing with its psychometric properties in a clinical sample of patients with schizophrenia. METHODS Two hundred forty-one patients from 10 Adult Mental Health Care Centers (AMHCC) meeting the following inclusion criteria were included: (1) International Classification of Diseases-10 or ICD-10 diagnosis of schizophrenia, (2) Global Assessment of Functioning scores or GAF ≤ 50, 3) Illness duration of more than 2 years and (4) Clinical stability at assessment time. Patients were evaluated at baseline and at one-year follow-up regarding quality of life (QOL), clinical variables and other psychosocial measures. RESULTS Internal consistency was excellent for the total WHOQOL-BREF (0.88 at baseline and 0.89 at follow-up) and adequate (0.65-0.78 at baseline; 0.66-0.79 at one-year follow-up) for the WHOQOL-BREF domains. Correlations between WHOQOL-BREF scores and those of global functioning, psychiatric symptoms, disability and social support ranged between small and large. There were significant differences between groups of patients with schizophrenia in the WHOQOL-BREF. Patients who were anxious, disabled, lacked social support and used more social services scored significantly lower in some or all WHOQOL-BREF domains. Changes in WHOQOL-BREF scores were positively associated with changes over time in global functioning, social support and use of health services, and negatively with psychiatric symptoms and disability (correlation coefficients between small and moderate). After one-year follow-up, patients improved in overall functioning and there was a decrease in psychiatric symptoms. CONCLUSIONS This study shows that the WHOQOL-BREF has good reliability and validity, and suggests that it is suitable for the assessment of QOL in patients with schizophrenia.
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Affiliation(s)
- Laia Mas-Expósito
- Department of Research, Centre d'Higiene Mental Les Corts, c/Numància 103-105 baixos, 08029, Barcelona, Spain.
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Ogino S, Miyamoto S, Tenjin T, Kitajima R, Ojima K, Miyake N, Funamoto Y, Arai J, Tsukahara S, Ito Y, Tadokoro M, Anai K, Tatsunami S, Kubota H, Kaneda Y, Yamaguchi N. Effects of discontinuation of long-term biperiden use on cognitive function and quality of life in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:78-83. [PMID: 20828595 DOI: 10.1016/j.pnpbp.2010.08.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 08/23/2010] [Accepted: 08/30/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND The high use of long-term antiparkinsonian anticholinergic drugs with antipsychotics has been identified as an important issue in the treatment of schizophrenia in Japan. The aim of this study was to evaluate the effects of gradual discontinuation of biperiden, an anticholinergic drug, on cognitive function and quality of life (QOL) in schizophrenia. METHODS Thirty-four schizophrenic patients who had received a second-generation antipsychotic (SGA) with concomitant biperiden for at least 3 months were enrolled. Before and 4 weeks after discontinuation of biperiden, the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J) and the Schizophrenia Quality of Life Scale (SQLS-J) were administered. Clinical evaluation also included the Positive and Negative Syndrome Scale (PANSS). To compare the practice effect on BACS-J, 10 chronic patients with schizophrenia were assessed without tapering biperiden. RESULTS Biperiden was discontinued safely in most patients, and no emergent extrapyramidal symptoms were observed. Significant improvements were shown in attention, processing speed, and composite score, as measured by the BACS-J without practice effect. In addition, the psychosocial condition score on the SQLS-J and the general psychopathology score on the PANSS significantly improved after biperiden discontinuation. CONCLUSION Discontinuation of long-term biperiden use may be warranted in patients with schizophrenia treated with SGAs, as it may improve cognitive function, subjective QOL, and psychiatric symptoms with no significant adverse effects.
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Affiliation(s)
- Shin Ogino
- Department of Neuropsychiatry, St Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
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Kujur NS, Kumar R, Verma AN. Differences in levels of disability and quality of life between genders in schizophrenia remission. Ind Psychiatry J 2010; 19:50-4. [PMID: 21694792 PMCID: PMC3105560 DOI: 10.4103/0972-6748.77638] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND QOL (Quality of life) and Disability have been considered inevitable components of schizophrenia from the Biopsychosocial point of view. Studies from over the world have reported significantly lower levels of QOL and higher levels of disability in schizophrenia; but there are equivocal results revealing differences in levels of disability and QOL between genders in schizophrenia. AIM To find out the difference in the levels of QOL and disability in both the genders in schizophrenia remission. MATERIALS AND METHODS This is cross-sectional study. Sixty patients who gave consent for their participation in the study and satisfying the criterion of remission of schizophrenia, in the age group of 18-60 years, were selected. A purposive sampling technique was used. There were 34 males and 26 females in the study sample. WHO-QOL-BREF ( World Health Organization, Quality of life BREF) and WHO-DAS (World Health Organization-Disability Assessment Schedule) were administered. RESULTS There was a statistically significant difference in the levels of QOL and disability between the genders. Higher scores of WHO-QOL-BREF were seen in the male group, and higher scores of WHO-DAS were seen in the female group. CONCLUSION Male group had better QOL, and the female group had higher disability.
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Affiliation(s)
- Nishi Suchita Kujur
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Science, Ranchi (JKD), India
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