Eack Shaun M, Newhill Christina E
School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning Pittsburgh, PA 15260, USA.
Schizophr Bull. 2007 Sep;33(5):1225-37. doi: 10.1093/schbul/sbl071. Epub 2007 Jan 4.
Quality of life (QoL) has been recognized as an important outcome of schizophrenia treatment, yet the determinants of QoL for individuals with schizophrenia are not well known. Research has consistently found psychiatric symptoms to be negatively related to QoL, however, findings concerning the strength of these relationships have been mixed, making it difficult to determine the degree to which such symptoms are related to poor QoL. This research presents a systematic meta-analysis of studies examining the relationship between psychiatric symptoms and QoL in schizophrenia, in an effort to elucidate the determinants of QoL for this population. A total of 56 studies were extracted from literature searches of relevant databases for empirical reports published between 1966 and 2005 examining the relationship between positive, negative, and/or general psychiatric symptoms and QoL. Weighted effect size analyses revealed small relationships between psychiatric symptoms and QoL, with general psychopathology showing the strongest negative associations across all QoL indicators. Moderator analyses indicated that variation in effect sizes could be accounted for by differing operationalizations of QoL, study design, sample, and participant treatment setting. In particular, positive and negative symptoms were more strongly related to poor QoL among studies of schizophrenia outpatients, whereas general psychopathology showed a consistent negative relationship with QoL across all study samples and treatment settings. Implications for future research and treatment development are discussed.
生活质量（QoL）已被公认为是精神分裂症治疗的一项重要成果，然而，精神分裂症患者生活质量的决定因素尚不明确。研究一直发现精神症状与生活质量呈负相关，然而，关于这些关系强度的研究结果却参差不齐，这使得难以确定此类症状与生活质量低下的关联程度。本研究对考察精神分裂症患者精神症状与生活质量之间关系的研究进行了系统的荟萃分析，以阐明该人群生活质量的决定因素。通过对相关数据库的文献检索，共提取了56项研究，这些研究是关于1966年至2005年间发表的实证报告，考察阳性、阴性和/或一般性精神症状与生活质量之间的关系。加权效应量分析显示精神症状与生活质量之间存在微弱关系，在所有生活质量指标中，一般性精神病理学表现出最强的负相关。调节因素分析表明，效应量的差异可由生活质量的不同操作化、研究设计、样本和参与者治疗环境来解释。特别是，在精神分裂症门诊患者的研究中，阳性和阴性症状与生活质量低下的关系更为密切，而一般性精神病理学在所有研究样本和治疗环境中均与生活质量呈现出一致的负相关。文中还讨论了对未来研究和治疗发展的启示。
