Ethnicity and life quality of recently discharged inpatients with schizophrenia

Three months after inpatient discharge, quality of life was examined in 259 individuals with schizophrenia. As in findings by Lehman, Rachuba, and Postrado (1995), Black participants reported a higher quality than Whites after controlling for gender, degree of psychopathology, functioning level, substance abuse, and baseline life quality. Implications are discussed.     

Predictors of subjective and objective quality of life in outpatients with schizophrenia

Aim: In recent years, greater attention has been given to quality of life (QOL) in schizophrenia and several studies reported that negative and depressive symptoms and cognitive dysfunction are related to patient QOL. But because a variety of QOL measures have been used in the previous studies, there seems to be no unanimous predictors for subjective and objective QOL. The purpose of the present study was to elucidate the relationship between clinical variables and subjective and objective QOL in outpatients with schizophrenia, using schizophrenia disease‐specific QOL measures. Particular attention was paid to cognitive function as a predictor of QOL. Methods: Schizophrenia symptoms of the Positive and Negative Syndrome Scale (PANSS) were divided into five factors: positive factor, negative factor, cognitive factor, emotional discomfort, and hostility. The study sample consisted of 84 schizophrenia outpatients. Subjective and objective QOL were assessed with Schizophrenia Quality of Life Scale (SQLS) and the Quality of Life Scale (QLS), respectively. Results: Subjective QOL correlated significantly with emotional discomfort, positive factor, negative factor, extrapyramidal symptoms and cognitive factor, while objective QOL correlated with negative factor, cognitive factor, emotional discomfort, extrapyramidal symptoms, and dose of antipsychotics. Total score and three of four subscales in the QLS correlated significantly with cognitive factor, while cognitive factor had a significant correlation with only one of three scales of SQLS. Stepwise regression showed that subjective QOL was significantly predicted by emotional discomfort and extrapyramidal symptoms, while negative factor was the most important predictor of objective QOL. Conclusion: Cognitive dysfunction had a greater influence on objective QOL than subjective QOL. Treating depressive and negative symptoms and extrapyramidal symptoms might contribute to enhanced subjective and objective QOL.     

社区与住院精神分裂症患者生活质量的比较分析

目的　对社区康复期与住院精神分裂症患者的生活质量进行了调查和比较分析。方法　用健康调查表SF - 36调查社区康复期与住院精神分裂症患者 ,并设正常对照组。结果　正常对照组的SF - 36因子分体能(PF)、体能影响 (RP)、一般健康 (GH)、社会活动 (SF)、心理健康 (MH)均高于社区康复期精神分裂症患者 ,差异有极显著性 (P <0 0 1) ;正常对照组在体能 (PF)、体能影响 (RP)、社会活动 (SF)因子分均高于住院治疗期精神分裂症患者 ,差异有极显著性 (P <0 0 1) ;社区康复期精神分裂症患者在体能 (PF)、体能影响 (RP)、精神影响 (RE)分高于住院治疗期精神分裂症患者 ,且差异有极显著性 (P <0 0 1) ,而后者一般健康 (GH)、精力 (VT)、心理健康 (MH)分高于前者 ,且差异有显著性 (P <0 0 5 )。结论　社区康复期精神分裂症患者在躯体健康方面优于住院治疗期精神分裂症患者 ,后者在精神健康方面优于社区康复期精神分裂症患者。     

住院精神分裂症患者及其家属的生活质量调查

目的了解精神分裂症患者及其家属的生活质量，探索影响精神分裂症患者及其家属生活质量的主要因素。方法应用多种心理评定量表对60例精神分裂症患者与60名家属进行评估。结果男、女患者的生活质量无明显差异；男性家属的生活质量比女性家属普遍高。焦虑、抑郁情绪，工作情况不稳定，年龄小，文化程度高，BPRS总分高，SDSS总分低等因素对患者的生活质量的各个维度均有一定影响；家属生活质量的影响因素主要与他们自身的焦虑、抑郁情绪有关，还与家庭中有无其他子女有关。结论加强社会支持及时治疗及时改善情绪，可能会提高他们的生活质量。     

长期住院慢性精神分裂症患者生活质量及影响因素分析

目的 探讨长期住院的慢性精神分裂症患者的生活质量及影响因素。方法 采用阳性症状和阴性症状量表（PANSS）、治疗不良反应量表（TESS）、健康状况调查问卷（sF一36）以及自编患者一般情况调查表（人口学资料、病期、住院时间、临床用药、目前状态、躯体疾病）,对2012年8月～2013年8月的163例慢性精神分裂症住院患者进行评定,并与82名健康志愿者进行对照分析。结果 精神分裂症患者SF-36生活质量各维度评分均低于对照组,两组间差异有统计学显著意义（P〈0．01）;患者的生理机能与药物不良反应呈负相关（r=-0.290,P〈0．01）;躯体疼痛与患者的阳性症状（r=-0．144,P〈0．05）及阴性症状（r=-0．199,P〈0．05）呈负相关;一般健康状况与患者的阴性症状（r=-0．193,P〈0．05）及一般精神病理症状（r=-0．219,P〈0．01）呈负相关;精力与患者的阴性症状（r=-0．342,P〈0．01）及一般精神病理症状（r=-0．186,P〈0．05）呈负相关;社会功能与药物不良反应（r=-0．173,P〈0．05）呈负相关;情感职能与患者的阳性症状（r=-0．201,P〈0．05）呈负相关;精神健康与阴性症状（r=-0．214,P〈0．01）及一般精神病理症状（r=-0．168,P〈0．05）、药物不良反应（r=-0．194,P〈0．05）呈负相关。结论 长期住院的慢性精神分裂症患者的生活质量低下,影响因素是多方面的,包括患者的精神状态、药物疗效、不良反应等。     

Predictors of general quality of life and the mediating role of health related quality of life in patients with schizophrenia

Introduction  The concept ‘quality of life’ (QoL) has become increasingly important as an outcome measure in the evaluation of services and in clinical trials of people with schizophrenia. This study examines the mediating role of health related quality of life (HRQoL) in the prediction of general quality of life (GQoL). Method  QoL and other patient- and illness characteristics (psychopathology, overall functioning, illness history, self-esteem and social integration) were measured in a group of 143 outpatients with schizophrenia. GQoL was measured by the Lancashire Quality of Life Profile and HRQoL was measured by the MOS SF-36. To test the temporal stability of our findings, assessments were performed twice with an 18-month interval. Results  We found that patient’s GQoL is predicted mainly by anxiety and depression and self-esteem and to a lesser extent by global functioning and social integration. At both time intervals HRQoL appeared to be a significant mediator of the relationship between anxiety and depression and self esteem versus patient’s GQoL. Conclusions  The results of this study are important for mental health professionals, as these provide more insight in the mechanisms by which they could improve the GQoL of their patients with schizophrenia. The results confirm that diagnosis and treatment of anxiety and depression in outpatients with schizophrenia deserves careful attention of clinicians. Also strategies and specific interventions to improve self-esteem of patients with schizophrenia are very important to maximise patient’s QoL.     

Education, ethnicity, and subjective life quality of recently discharged inpatients with schizophrenia

To inform psychiatric practice and research that enhances subjective quality of life (SQL) in diverse persons with schizophrenia, this study explored whether SQL differs in blacks and whites with varying educational attainment. Participants were interviewed upon discharge from 4 New York City psychiatric hospitals and after 3 months in community care (N = 264, mean age of 37 years, 61% male, 56% black). Linear regression equations predicted white and black SQL from educational attainment and control variables (ethnicity, age, functioning level, symptom severity). Educational accomplishment predicted lower SQL (F = 3.53, df = 4,227, p < 0.01), especially among whites (F = 5.87, df = 4,92, p < 0.001). However, the association was statistically insignificant in blacks who had SQL peaks and valleys with more years of school. Findings suggest that psychiatric care and research should account for educational and cultural variation in assessing and promoting SQL.     

慢性住院精神分裂症的生活质量及其相关因素研究

目的探讨慢性住院精神分裂症患者的生活质量及其相关因素。方法90例住院患者都采用生活质量量表、汉密顿焦虑量表及汉密顿抑郁量表检测,并比较各项数据。结果根据男性与女性患者之间的检测数据,在生活质量量表的各项目中的PF分值差异具有统计学意义(P<0.05);而RP、SF、RE的分值差异则呈现显著的统计学意义(P<0.01)。因此,上述结果提示男性患者生活质量的部分主要项目比女性好。另一方面,在较好家庭与较差家庭支持之间,焦虑量表与抑郁量表的总分值之间,都呈现显著的统计学意义,这也提示抑郁和焦虑情绪在较好家庭支持时可能有所减少。结论尽最大努力促进生活质量中的主项如PF、RP、SF、RE以及家庭支持等,能改善慢性住院精神分裂症患者的康复效果。     

精神分裂症和双相情感障碍住院患者家属的生活质量及社会支持状况

目的：探讨精神分裂症和双相情感障碍（躁狂发作或抑郁发作及混合发作）住院患者家属生活质量及社会支持状况。方法以精神分裂症和双相情感障碍住院患者的家属为研究对象,进行一般调查表（自制）、简明健康调查量表（SF－36）、社会支持评定量表（SSRS）等检测,并对结果进行统计分析。结果（1）精神分裂症和双相情感障碍住院患者家属生活质量的各项指标均低于全国平均水平,差异有统计学意义（P ＜0．01）。（2）精神分裂症和双相情感障碍住院患者家属社会支持总分与全国常模比较,差异无统计学意义（P ＞0．05）;患者家属文化程度越高,获得的社会支持情况越好,但差异无统计学意义（P ＞0．05）;双相情感障碍患者家人获得的社会支持状况好于精神分裂症患者家属,差异有统计学意义（ P＝0．049）。结论精神分裂症和双相情感障碍住院患者家属的生活质量令人担忧,这可能与疾病的特点有关。     

Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis.

OBJECTIVE: To identify clinically useful predictors of adherence to medication among persons with schizophrenia. METHOD: We evaluated levels of compliance with neuroleptic medication among 32 consecutive admissions with DSM-III-R schizophrenia from a geographically defined catchment area using a compliance interview. We also assessed symptomatology, insight, neurological status and memory. RESULTS: Less than 25% of consecutive admissions reported being fully compliant. Drug attitudes were the best predictor of regular compliance, symptomatology the best predictor of noncompliance, and memory the best predictor of partial compliance with neuroleptic medication. CONCLUSIONS: These data emphasise the complexity of factors that influence whether a person adheres to his medication regimen. Furthermore, they suggest that these factors may vary within the same person over time.     

住院精神分裂症患者生存质量研究

目的：探讨住院精神分裂症患者的生存质量及其影响因素。方法：量表采用MOS健康状况调查问卷(SF-36)、简明精神病评定量表(BPRS)、副反应量表(TESS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)等对125例住院精神分裂症患者进行评定，并与120名正常健康者进行对照。结果：精神分裂症患者SF-36评分显著低于对照组；家庭支持少、病程短、年龄轻、初次住院、住院时间短的患者生存质量差。多因素逐步回归分析显示，影响患者生存质量的主要因素依次为BPRS、SAS、TESS和病程。结论：住院精神分裂症患者的生存质量全面低下，影响因素是多方面的，应予以重视。     

Neurocognitive deficits and quality of life in outpatients with schizophrenia

The purpose of this cross-sectional study was to examine the relationships between neurocognitive deficits and quality of life for patient with schizophrenia. Fifty-seven schizophrenic outpatients (38 men and 19 women) were assessed for neurocognitive deficits using the Wisconsin Card Sorting Test (WCST) and all patients completed the PCASEE (P=physical, C=cognitive, A=affective, S=social, E=economic-social, and E=ego functions) questionnaire to assess their quality of life. We assessed psychiatric symptoms using the Schedule for the Assessment of Positive Symptoms (SAPS) and the Schedule for the Assessment of Negative Symptoms (SANS). We rated the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal side effects. Pearson correlational analyses were conducted to assess the relationships among measures of quality of life, neurocognitive functioning, symptoms, and extrapyramidal side effects. There were significant relationships among the total score of the PCASEE questionnaire and the SANS total score and the AIMS total score (P<.001). Small but significant associations were found among the total score of the PCASEE questionnaire and the SAPS total score and a number of nonperseverative errors (P<.05). Negative symptoms and extrapyramidal side effects in schizophrenia appear to have direct impact on the patient's perceived quality of life.     

Assessing quality of life in older persons with schizophrenia.

OBJECTIVE: There have been few studies of quality of life (QOL) indicators in older schizophrenic persons, and these studies have used narrow measures of QOL. The authors sought to demonstrate that self-appraisals of QOL are useful and valid in older schizophrenic persons. A second aim was to provide provisional support for a model of QOL in this population. METHODS: The sample was 99 community-dwelling schizophrenic persons age 55+ and a community-comparison group (N=84). Using the Quality of Life Index (QLI), they compared the variable sets of their model (Objective, Subjective, and Psychiatric domains) for the schizophrenic and the community samples to determine whether the explained variance in the QLI was equivalent between groups for each of the three variable sets. To assess the model of QOL, for the entire sample, the global scale score of the QLI was regressed on three predictor variable sets, the three demographic covariates, and group membership. RESULTS: All of the group differences were considered "small effect sizes." There were no significant differences between groups in the individual-variable regression coefficients. For the entire sample, when the QLI was regressed on the three predictor variable sets simultaneously, the model explained 61% of the variance in the QLI, and group membership was not significant. CONCLUSIONS: The analyses demonstrated the reliability and validity of the QLI in older schizophrenic persons and supported its validity by producing results comparable to general-community residents. The overall model was highly significant and should serve as basis for future studies of QOL.     

Sexuality and quality of life of patients with schizophrenia

Patients with schizophrenia continue to have sexual lives despite the nature of their illness. Sexuality, sexual relationships and sexual functioning are all important quality-of-life issues for these patients. Clinicians should be aware of this and not be hesitant to inquire as to the patient's experience and functioning in these areas. The importance of the patient's sexual life should be reflected in our quality of life questionnaires, and be incorporated as part of psychiatric rehabilitation programs through formal sex education. (Int J Psych Clin Pract 2000; 4:29-33)     

Predictors of change in life skills in schizophrenia after cognitive remediation

Few studies have investigated predictors of response to cognitive remediation interventions in patients with schizophrenia. Predictor studies to date have selected treatment outcome measures that were either part of the remediation intervention itself or closely linked to the intervention with few studies investigating factors that predict generalization to measures of everyday life-skills as an index of treatment-related improvement. In the current study we investigated the relationship between four measures of neurocognitive function, crystallized verbal ability, auditory sustained attention and working memory, verbal learning and memory, and problem-solving, two measures of symptoms, total positive and negative symptoms, and the process variables of treatment intensity and duration, to change on a performance-based measure of everyday life-skills after a year of computer-assisted cognitive remediation offered as part of intensive outpatient rehabilitation treatment. Thirty-six patients with schizophrenia or schizoaffective disorder were studied. Results of a linear regression model revealed that auditory attention and working memory predicted a significant amount of the variance in change in performance-based measures of everyday life skills after cognitive remediation, even when variance for all other neurocognitive variables in the model was controlled. Stepwise regression revealed that auditory attention and working memory predicted change in everyday life-skills across the trial even when baseline life-skill scores, symptoms and treatment process variables were controlled. These findings emphasize the importance of sustained auditory attention and working memory for benefiting from extended programs of cognitive remediation.     

Predictors and indicators of quality of life in patients with Closed-Head injury

Abstract

This study examined predictors and indicators of quality of life in 71 patients with closed-head injury (CHI), 2-4 years postinjury. Predictors included premorbid characteristics and acute injury-related data. Indicators included follow-up data, e.g., neuropsychological functioning. Exploratory canonical correlation analyses demonstrated that the combination of the predictor variable, initial Glasgow Coma Scale score, and indicator variables of neuropsychological data in the areas of motor functioning, memory, and constructional ability were related most strongly to quality of life as reported by the patients. Severity of head injury and motor disability also related strongly to quality of life, based on reports by relatives (n = 68) on the Katz Adjustment Scale (Relatives' Form). These findings suggest that quality of life is adversely affected by increased severity of head injury and greater residual motor deficits. Implications of these findings for treatment and recovery are discussed.     

Predictors and indicators of quality of life in patients with closed-head injury

This study examined predictors and indicators of quality of life in 71 patients with closed-head injury (CHI), 2-4 years postinjury. Predictors included premorbid characteristics and acute injury-related data. Indicators included follow-up data, e.g., neuropsychological functioning. Exploratory canonical correlation analyses demonstrated that the combination of the predictor variable, initial Glasgow Coma Scale score, and indicator variables of neuropsychological data in the areas of motor functioning, memory, and constructional ability were related most strongly to quality of life as reported by the patients. Severity of head injury and motor disability also related strongly to quality of life, based on reports by relatives (n = 68) on the Katz Adjustment Scale (Relatives' Form). These findings suggest that quality of life is adversely affected by increased severity of head injury and greater residual motor deficits. Implications of these findings for treatment and recovery are discussed.     

首发精神分裂症患者的生活质量评估

目的评估首发分裂症患者的生活质量，及生活质量与精神症状的相关性。方法评估447例患者基线、随访6个月、随访1年时阳性和阴性症状量表（PANSS）、健康状况调查问卷（SF-36）、社会功能缺陷筛选量表（SDSS）、生活满意度量表（LSR）。主要根据SF-36评估首发分裂症患者的生活质量，并将SF-36与PANSS、SDSS、LSR作相关分析。结果首发精神分裂症患者在躯体角色功能（RP）、社会功能（SF）、情绪角色功能（RE）3个维度平均分显著低于杭州市居民的数据。除精力（VT）外，其余7个维度与PANSS的阳性症状分、阴性症状分、一般精神病理分以及SDSS均呈负相关，与LSR呈正相关。而VT与PANSS的阴性症状分及LSR呈负相关。随访1年问躯体健康（PF）、躯体角色功能（RP）、躯体疼痛（BP）、总体健康（GH）、社会功能（SF）、情绪角色功能（RE）、心理健康（MH）等7个维度得分显著提高。结论首发分裂症患者的情绪角色功能、躯体角色功能和社会功能受损明显，经1年治疗后上述功能均能明显改善。除精力感外，精神症状缓解越明显，生活质量越高，提示了早期治疗的重要性。同时也表明SF-36可适用于评估分裂症患者的生活质量。     

Psychopathology and quality of life in schizophrenia.

This study was conducted to evaluate the relationship between psychopathology and quality of life in individuals with schizophrenia. The findings indicate that psychopathology, as determined by total Brief Psychiatric Rating Scale (BPRS) score, correlates negatively with global life satisfaction and subjective quality of life subscales, but not with objective ones. When positive and negative symptom clusters were examined, negative symptoms appeared to have a greater impact on subjective measures of quality of life.