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Neurocognitive,clinical and functional correlates of subjective quality of life in Asian outpatients with schizophrenia
Authors:Puay San Woon  Ming Ying Chia  Wai Yen Chan  Kang Sim
Institution:1. Research Division, Institute of Mental Health/Woodbridge Hospital, Singapore;2. Department of General Psychiatry, Institute of Mental Health/Woodbridge Hospital, Singapore
Abstract:Quality of life (QOL) impairment is evident in patients with schizophrenia and is increasingly recognised as an important evaluation criterion of treatment outcome. Hence, this study aimed to identify the neurocognitive, clinical and functional parameters associated with subjective QOL in patients with schizophrenia within an Asian context, and specifically in an outpatient setting. This study was conducted on 83 outpatients with DSM-IV diagnosis of schizophrenia, and 47 age- and gender-matched healthy controls. All participants were administered with the World Health Organisation Quality of Life Assessment-Brief Form (WHOQOL-BREF) and Brief Assessment of Cognition in Schizophrenia (BACS), to measure quality of life and cognitive function respectively. Patients were also assessed for severity of psychopathology, as well as level of psychosocial functioning, using the Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) rating scales respectively. Specific psychopathology (greater severity of PANSS negative symptoms, general psychopathology subscale scores), cognitive deficits (working and verbal memories), and lower GAF scores were correlated with poorer QOL in patients. Multivariate analyses revealed that younger age, being single and lower level of psychosocial functioning were associated with poorer QOL but level of psychosocial functioning did not appear to mediate the effects of symptoms and neurocognitive deficits on QOL. Overall, this study highlighted the need for clinicians to pay more attention to these clinical, neurocognitive and functional parameters and their integrative relationships with QOL in order to optimise the treatment outcomes of patients with schizophrenia.
Keywords:BACS  Brief Assessment of Cognition in Schizophrenia  DSM-IV  Diagnostic and Statistical Manual of Mental Disorders IV  GAF  Global Assessment of Functioning  PANSS  Positive and Negative Syndrome Scale  QOL  Quality of life  S  D    standard deviation  SCID-NP  Structured Clinical Interview for DSM-IV Axis I disorders-Non-patient version  SCID-P  Structured Clinical Interview for DSM-IV Axis I disorders-Patient version  SPSS  Statistical Package for Social Sciences  WHOQOL-BREF  World Health Organisation Quality of Life Assessment-Brief Form  WRAT  Wide Range Achievement Test
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