Relationship of symptomatic remission with quality of life and functionality in patients with schizophrenia

Objective

The aim of this study was to investigate the relationship between remission and quality of life (QoL) of patients with schizophrenia.

Method

Quality of life was investigated with the Quality-of-Life Scale, the Personal and Social Performance Scale (PSP), and the Evaluation of Functional Remission Scale in 102 outpatients with schizophrenia. Positive and Negative Syndrome Scale and Calgary Depression Scale for Schizophrenia (CDSS) were used to assess symptom severity. Remission was defined based on the Andreasen et al criteria (2005).

Results

The remission group had higher levels of QoL and functionality as measured by the Quality-of-Life Scale (P = .001), PSP (P = .001), and Evaluation of Functional Remission Scale (P = .001). The remission group also had higher employment rates, lower smoking rates, and less depressive symptoms. We found that negative (P = .001) and positive symptoms of the Positive and Negative Syndrome Scale (P = .05) and CDSS score (P = .005) independently contributed to PSP score in a linear regression analysis. Years of education and positive symptoms were related to CDSS score. All of the 3 scales that we used to assess QoL and functionality were highly correlated with each other. In addition, the opinions of patients or relatives/partners about functionality of the patient was highly correlated with all of the scales.

Conclusion

We found significant differences between patients with schizophrenia with and without remission for QoL and functionality. Relative/partner's evaluation of functional status provides a reliable measure of QoL as well.     

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)     

Anticipated discrimination is related to symptom severity,functionality and quality of life in schizophrenia

The aim of this study is to evaluate a possible relationship between the level of anticipated discrimination with severity of symptoms and functionality. We included 103 patients with schizophrenia. Severity of symptoms was measured by PANSS and Calgary Depression Scale for Schizophrenia. Quality of life (QL) and functionality were measured by using QLS, PSP and Functional Remission of General Schizophrenia Scale (FROGS). Anticipated/experienced discrimination was evaluated with four selected items from Discrimination and Stigma Scale.     

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。     

Emotional expressiveness and the quality of life of patients with schizophrenia

BACKGROUND: The present research aims to study the association between emotional expressiveness of primary care-givers and quality of life of patients with schizophrenia. METHOD: The data for the present study were collected from 174 purposively selected patients with schizophrenia and their primary care-givers. The Quality of Life Interview (QOLI) (Lehman 1988) was used to collect information related to the quality of life of patients. The care-givers' emotional expressiveness was assessed using three questions on home environment from Disability Assessment Schedule (WHO/DAS) (WHO 1988). RESULTS: Three components of emotional expressiveness were included in the present research, namely, emotional involvement, control and attitude of rejection. Among these three components, emotional involvement of key care-givers was found to have a significant association with quality of life of schizophrenia patients. CONCLUSION: Based on this result, the present study argues that emotional involvement of key care-givers needs careful attention while planning psychosocial rehabilitation programmes aimed at enhancing the quality of life of schizophrenia patients.     

精神分裂症患者生活质量与药物治疗态度的相关性

目的探讨精神分裂症患者生活质量与药物治疗态度的相关性。方法连续入组151例在广州市脑科医院住院的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者,分别采用健康状况量表(SF-36)、药物态度清单(DAI)、阳性和阴性症状量表(PANSS)评定其生活质量、药物治疗态度和临床症状。采用多重逐步回归分析生活质量的影响因素。结果治疗态度积极组57例,男性38例(66.7%),治疗态度消极组94例,男性40例(42.6%),积极组男性比例高于消极组;积极组SF-36心理健康维度(MCS)评分(46.8±9.1)分,消极组(41.0±10.8)分,两组比较差异有统计学意义(P0.05);多重回归分析显示患者的药物治疗态度是生活质量的影响因素(B=2.025,β=0.309,P0.05)。结论精神分裂症患者的药物治疗态度越积极,生活质量越好。     

Body mass index and quality of life in community-dwelling patients with schizophrenia

OBJECTIVE: To examine the associations between sociodemographic variables, body weight and quality of life in schizophrenic outpatients. METHODS: Assessments included an interview to obtain sociodemographic data, administration of a Quality of Life questionnaire (the MOS SF-36) and measurement of height and weight. Body mass index was calculated (kg/m(2)). SF-36 subscores were examined for statistical differences based on BMI categories: healthy weight (BMIor=30). Correlations with sociodemographic variables were also examined. RESULTS: Body weight was inversely correlated (level p相似文献   

The impact of the interviewer-interviewee relationship on subjective quality of life ratings in schizophrenia patients

Subjective quality of life (SQOL) ratings are usually based on interviews. This study examined in which way patients' ratings differ depending on whom they are interviewed by. SQOL was assessed in 78 schizophrenia patients in an out patient clinic and in sheltered living arrangements. Using patients randomly allocated to two interview situations: one group was interviewed by external researchers, the other group by their case managers. On average, more favourable ratings were elicited by case managers. Some of the differences were statistically significant and substantial in size. Yet, opposing differences were also found regarding some life domains in one group. It may be concluded that a significant impact of the interviewer-interviewee relationship on SQOL ratings may exist, but that it is not consistent, unidirectional and uniform regarding life domains and across different settings and samples.     

Sexual functioning, psychopathology and quality of life in patients with schizophrenia

OBJECTIVE: The present study was to characterize relationships among sexual functioning, schizophrenia symptoms and quality of life measures. In addition, sexual functioning was compared among patients treated with different antipsychotic agents. METHODS: Outpatient subjects were assessed using the Positive and Negative Symptom Scale (PANSS), the Changes in Sexual Functioning Questionnaire (CSFQ) and the Hamilton Rating Scale for Depression (HAMD). Quality of life was assessed using two different instruments: observer-rated Heinrich's Quality of Life Scale (QLS) and self-rated The Behavior and Symptom Identification Scale (BASIS). RESULTS: One hundred twenty-four patients with schizophrenia or schizoaffective disorder were enrolled in the study. Eight-six patients (69%) completed at least part of the CSFQ assessment, which generated at least one valid subscale score. High rates of sexual impairment were found in both male and female patients (65%-94% across different subscales). For males, higher scores on the PANSS-positive subscale were associated with a lower frequency of sexual activity (p=0.04). For females, higher scores on the PANSS-positive subscale and PANSS-general psychopathology subscale were significantly associated with more difficulty in both sexual arousal and orgasm (p's<0.05). For both males and females, there were no significant relationships between any CSFQ subscale measures and the quality of life measures (p's>0.05). No significant differences were found among three antipsychotic treatment groups (clozapine, olanzapine or typical agents) on any CSFQ subscale measures or quality of life measures after controlling for PANSS total scores (p's>0.05). CONCLUSIONS: Effective treatment strategies still need to be developed to address sexual dysfunction and quality of life in patients with schizophrenia.     

精神分裂症患者生活质量与非理性信念的关系研究

目的分析探讨精神分裂症患者生活质量与非理性信念的关系,为认知行为治疗提高患者的生活质量提供理论指导。方法选取符合DSM—IV中精神分裂症诊断标准的医院门诊和住院患者共200例,采用世界卫生组织生存质量测定量表简表（wHOQOL—BREF）和非理性信念量表（IBS）对患者进行测评,收回有效问卷182例,分析患者生活质量与非理性信念的相关性。结果患者生活质量总分及4个因子分与非理性信念的低挫折耐受呈负相关（r分别为-0．348,-0．405,-0．309,-0．256,-0．394;P〈0．01）,与概括化评论呈负相关（r分别为-0．357,-0．401,-0．325,-0．295,-0．413;P〈0．01）。低挫折耐受和概括化评论可以作为总体生活质量和心理因子的预测指标（F分别为21．231,21．015;P〈0．01）;概括化评论可以作为总体生活质量及生理、社会关系、环境因子的预测指标（F分别为15．292,12．020,9．011;P〈0．01）。结论精神分裂症患者的非理性信念影响患者的生活质量的各个层面,非理性信念中的低挫折耐受和概括化评论可作为患者生活质量的预测指标。     

Sleep quality in caregivers of patients with Alzheimer's disease and Parkinson's disease and its relationship to quality of life

ABSTRACT Background: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers' sleep problems and their quality of life (QoL). Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire. Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain. Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.     

Sexual dysfunction and its impact on quality of life in Chinese patients with schizophrenia treated in primary care

PurposeSexual dysfunction in schizophrenia patients is common. In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. Illness- or treatment-related sexual dysfunction in this patient population has been never studied. This study describes the prevalence and correlates of sexual dysfunction and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China.MethodA total of 607 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. Patients' socio-demographic and clinical characteristics including sexual function and QOL were recorded using a standardized protocol and data collection.ResultsSexual dysfunction was present in 69.9% of all patients; 60.7% in males and 80.6% in females. Multiple logistic regression analysis revealed that female gender, being single, older age and use of first-generation antipsychotics were independently and significantly associated with more sexual dysfunction accounting for 23.5% of its variance (P < 0.001). Unexpectedly, sexual dysfunction was not associated with lower QOL.ConclusionsHigh rate of sexual dysfunction was reported in the majority of patients with schizophrenia treated in primary care in China. Given its negative impact on social adjustment, QOL and treatment adherence, efforts should be made to address sexual dysfunction in this patient population.     

Subjective and external assessments of quality of life in schizophrenia: relationship to insight.

OBJECTIVE: This study assessed the manner in which insight influenced schizophrenic patients' evaluation of their objective life conditions and the concurrent validity between patients' and clinicians' assessments of patients' global quality of life. METHOD: Forty out-patients who fulfilled DSM-III-R criteria for schizophrenia were independently interviewed using the Lancashire Quality of Life Profile and the Standard of Living Interview. Insight was assessed using a self-report questionnaire, the Insight Scale. RESULTS: For insightful patients there was a significant but modest correlation between objective and subjective indicators of quality of life. Likewise, a significant correlation between subjective and external evaluations of global quality of life was limited to those individuals who had good insight. CONCLUSION: Diminished insight may limit the usefulness of the self-report methodology for assessing quality of life for some individuals with schizophrenia.     

精神分裂症患者生活质量研究进展

精神分裂症是严重危害人类健康的最常见的重性精神疾病之一.随着医学模式的转变及健康观念的不断完善,精神分裂症的治疗目标不仅仅是缓解症状、降低复发率,更重要的是促进个体在躯体、心理、社会功能诸多方面达到良好状态,即注重患者生活质量的改善.     

The quality of life of patients with paranoid schizophrenia in London and Berlin

This study compared the subjective and objective quality of life and needs of patients with paranoid schizophrenia between inner city areas in Berlin (69 patients) and London (75 patients). Quality of life was assessed by means of the Lancashire Quality of Life Profile (German version Berliner Lebensqualitatsprofi), and need was quantified using the Camberwell Assessment of Need (German version Berliner Bedurfnisinventar). The hypotheses tested were that although Berlin patients may rate more highly on objective quality of life measures, the subjective quality of life would be similar as patients would judge their quality of life against their local expectations. The findings supported the first part of the hypothesis as on the objective measures the Berlin group was significantly better off financially and in living conditions, and had significantly fewer material needs. However, despite having more severe psychopathology, the Berlin groups' scores on global subjective quality of life were also higher. On particular life domains, subjective quality of life did not always reflect objective measures and sometimes went in the reverse direction. We concluded that the relationship between subjective and objective quality of life is complex, and great caution must be exercised in making quality of life comparisons between different cultures.