Quality of Life Assessment in Turkish Patients with Schizophrenia and Their Relatives

Second Generation Long-Acting Injectable Antipsychotics in Schizophrenia: The Patient's Subjective Quality of Life, Well-Being, and Satisfaction

Schizophrenia (SZ) is among the twenty most disabling diseases worldwide. Subjective quality of life, well-being, and satisfaction are core elements to achieving personal recovery from the disorder. Long-acting injectable second-generation antipsychotics (SGA-LAIs) represent a valid therapeutic option for the treatment of SZ as they guarantee good efficacy and adherence to treatment. The aim of this rapid review is to summarize the evidence on the efficacy of SGA-LAIs in improving subjective quality of life, well-being, and satisfaction. The PubMed database was searched for original studies using SGA, LAI, risperidone, paliperidone, aripiprazole, olanzapine, SZ, and psychosis as keywords. Twenty-one studies were included: 13 clinical trials, 7 observational studies, and 1 post hoc analysis. It has been shown that SGA-LAIs bring an improvement to specific domains of subjective and self-rated quality of life, well-being, or satisfaction in prospective observational studies without a control arm and in randomized controlled trials versus placebo. The superiority of SGA-LAIs as compared with oral equivalents and haloperidol-LAI has been reported by some randomized controlled and observational studies. Although promising, the evidence is still limited because of the lack of studies and several methodological issues concerning the choice of the sample, the evaluation of the outcome variables, and the study design. New methodologically sound studies are needed.

Quality of Life in Schizophrenia: A Meta-Analysis of Comparative Studies

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.

Care Burden Level and Mental Health Condition of the Families of Individuals With Mental Disorders

This study was conducted to assess burden of care levels and the mental health of the family members providing care to persons with mental disorders. The data were collected using the Information Form, Burden Assessment Scale (BAS) and General Health Questionnaire-12 (GHQ) (N=243). Of the caregivers included in this study, 67.49% were found to be at risk, and 47.3% of the caregivers were found to be at a high risk of developing mental disorders like depression and anxiety. A positive and statistically significant relation was identified between the BAS scores and GHQ scores of the caregivers (r=0.498; p=0.001).

Impact of panic attacks on quality of life among patients with schizophrenia

OBJECTIVE

Schizophrenia patients had decreased levels of quality of life compared to normal population. The aim of this study was to investigate the impact of panic attacks on quality of life in patients with schizophrenia.

METHODS

Eighty-eight patients with schizophrenia and 85 healthy subjects were included in the study. World Health Organization Quality of Life Instrument-Short Form (WHOQOL-Bref) was given to patients and healthy subjects to assess quality of life. Panic module of Structured Clinical Interview for DSM-IV (SCID) was administered to patients for diagnosis of panic attacks and panic disorder. Positive and Negative Syndrome Scale (PANSS) for symptom severity and Calgary Depression Scale (CDS) for depressive symptoms were administered to the patients.

RESULTS

Patients with schizophrenia demonstrated significantly lower scores compared to healthy controls in all domains of WHOQOL-Bref. Twenty-five patients (28.4%) with schizophrenia had panic attacks (PA) and 10 patients (11.4%) met criteria for panic disorder (PD). Schizophrenia patients with PA had significantly lower scores on psychological domain of WHOQOL-Bref compared to the patients without PA. Schizophrenic patients with panic attacks had higher CDS scores than patients without PA. In the multivariate regression analyses the variance in psychological domain of WHOQOL-Bref was explained by depression rather than panic attack.

CONCLUSION

In patients with schizophrenia comorbid panic attacks may have a negative impact on quality of life, which is associated with depression significantly. Panic attacks and depressive symptomatology must be examined comprehensively in order to improve quality of life in patients with schizophrenia.

Quality of life of relatives of patients with obsessive-compulsive disorder

BACKGROUND

Obsessive-compulsive disorder (OCD) affects the lives of both patients and their relatives. Clinical observations suggest that family members of patients with OCD are involved in the patients' rituals, often impairing their own everyday life.

OBJECTIVE

The objective of this study was to compare the quality of life (QoL) of relatives of patients with OCD with that of the general German population.

METHODS

Seventy-four relatives (29 parents, 33 spouses, 8 children, and 4 siblings) of patients with OCD (International Statistical Classification of Diseases, 10th Revision F42.0-F42.2) were recruited from the outpatient clinic for anxiety disorders of the University of Leipzig Department of Psychiatry. The WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organization, assessed QoL. These findings were compared with the QoL of a representative sample of the general German population.

RESULTS

Compared with that of the general population, the QoL of relatives of patients with OCD was significantly lower in the domains physical well-being, psychologic well-being, and social relationship.

CONCLUSIONS

Obsessive-compulsive disorder has an adverse effect on the subjective QoL of relatives of patients with OCD. Therefore, these findings suggest that professionals working with relatives must focus not only on the care given to persons with an illness but also on their relatives' situation and personal QoL.

Le rôle du soutien social, du fardeau familial et de la satisfaction des services dans la détresse psychologique et la qualité de vie des familles de personnes souffrant de schizophrénie

Cette étude, réalisée auprès d’un échantillon de convenance de 71 familles de personnes souffrant de schizophrénie, explore au moyen d’analyses de régression, les liens pouvant exister entre le soutien que ces familles reçoivent de leur réseau social personnel, le fardeau associé à leur rôle de parents, leur satisfaction des services en santé mentale, leur détresse psychologique et leur qualité de vie. Trois variables identifiées par les analyses, permettent de prédire 31 % de la variance de la détresse psychologique. Elles sont l’obtention de conseils et d’orientation provenant de leur réseau, le fardeau associé à l’implication dans les activités quotidiennes et la satisfaction des services. Cinq variables permettent d’expliquer 63 % de la qualité de vie. Il s’agit de l’obtention de conseils et d’orientation, la confirmation de leur valeur de la part des membres de leur réseau, le fardeau ressenti lors de l’implication dans les activités quotidiennes, le fardeau associé aux comportements problématiques et enfin la satisfaction des services. Les composantes du soutien social identifiées sont les prédicteurs les plus fortement associés à la santé mentale des familles de personnes souffrant de schizophrénie.