Quality of life and its predictors in first-episode schizophrenia and individuals at clinical high-risk for psychosis

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.

Exploring the interplay of psychiatric symptoms, antipsychotic medications, side effects, employment status, and quality of life in Chronic Schizophrenia

“…consistent with previous research on QoL in patients with schizophrenia, our study underscores the significant influence of depressive/anxiety symptoms and cognitive impairment on the overall QoL and subdomains. Numerous previous studies have documented the association in patients with schizophrenia including first-episode schizophrenia and chronic schizophrenia [ 5 , 6 , 13 , 38 , 39 ]. The prominence of depressive cognitions, including self-deprecation and feelings of hopelessness, suggests a need for targeted intervention to address these symptoms [ 5 ].…”

“…Numerous previous studies have documented the association in patients with schizophrenia including first-episode schizophrenia and chronic schizophrenia [ 5 , 6 , 13 , 38 , 39 ]. The prominence of depressive cognitions, including self-deprecation and feelings of hopelessness, suggests a need for targeted intervention to address these symptoms [ 5 ]. Treating depressive symptoms may emerge as a crucial clinical strategy for the improvement of subjective QoL in patients with schizophrenia [ 6 ].…”

“…Additionally, negative symptoms, such as apathy, anhedonia, and social withdrawal was also found to be associated with poor QoL [ 4 ]. Mao et al found that positive symptoms, particularly impulsivity/hostility, adversely affected physical and psychological aspects of QoL [ 5 ], while hallucinations and delusions had a weaker and less consistent relationship with QoL. Notably, affect symptoms including depressive symptoms were related to QoL in schizophrenia patients attract more attention in recent years [ 5 – 7 ] which needs further study.…”

“…Mao et al found that positive symptoms, particularly impulsivity/hostility, adversely affected physical and psychological aspects of QoL [ 5 ], while hallucinations and delusions had a weaker and less consistent relationship with QoL. Notably, affect symptoms including depressive symptoms were related to QoL in schizophrenia patients attract more attention in recent years [ 5 – 7 ] which needs further study. Furthermore, impaired neurocognition has been linked to reduced QoL [ 8 ].…”

“…However, other studies suggested that there was no correlation between positive symptoms, negative symptoms [ 6 ], and cognitive impairment with QoL [ 6 , 12 ]. These inconsistent results may be attributed to the heterogeneity of the patient population, the sample size, and the variety of assessment tools used to measure symptoms and QoL, including SQLS, 36-Item Short Form Survey (SF-36), the World Health Organization Quality of Life (WHOQOL)-Brief Form (BREF) [ 5 , 6 , 13 ].…”