Heider Dirk, Angermeyer Matthias C, Winkler Ines, Schomerus Georg, Bebbington Paul E, Brugha Traolach, Azorin Jean-Michel, Toumi Mondher
Department of Psychiatry, University of Leipzig, Johannisalle 20, 04317 Leipzig, Germany.
Schizophr Res. 2007 Jul;93(1-3):194-202. doi: 10.1016/j.schres.2007.03.005. Epub 2007 Apr 26.
Only a small number of studies have tried to identify factors influencing the subjective QoL of patients suffering from schizophrenia in a longitudinal design. These studies suffer from small clinical samples or compare baseline data only with a single follow-up. The European Schizophrenia Cohort Study overcomes these shortcomings by providing data from five time points on 1208 patients in psychiatric treatment in three European countries over a period of 2 years. QoL was measured with the brief version of Lehman's Quality of Life Interview. Random effects, between-effects and within-effects regression models were computed in order to measure the influence on subjective QoL of patients' socio-demographic and clinical characteristics and objective QoL. Objective QoL scores were generally found to be related to the equivalent subjective QoL scores. People's financial situation, and depressive and positive symptoms had a general effect on almost all subjective domains. The significant effects of objective finances on subjective domains like health and social relations raise interesting possibilities for intervention. Sufficient financial resources appear to be a necessary condition for achieving satisfactory QoL in schizophrenia patients. However, changes in individual's characteristics and circumstances did not relate as strongly as expected to changes in QoL, suggesting effective intervention may be difficult.
只有少数研究尝试采用纵向设计来确定影响精神分裂症患者主观生活质量的因素。这些研究存在临床样本量小的问题,或者仅将基线数据与单次随访数据进行比较。欧洲精神分裂症队列研究克服了这些缺点,它提供了来自三个欧洲国家1208名接受精神科治疗患者在2年期间五个时间点的数据。生活质量采用莱曼生活质量访谈简版进行测量。为了衡量患者的社会人口统计学和临床特征以及客观生活质量对主观生活质量的影响,计算了随机效应、组间效应和组内效应回归模型。客观生活质量得分通常被发现与相应的主观生活质量得分相关。人们的经济状况、抑郁症状和阳性症状几乎对所有主观领域都有普遍影响。客观经济状况对健康和社会关系等主观领域的显著影响为干预提供了有趣的可能性。充足的经济资源似乎是精神分裂症患者实现满意生活质量的必要条件。然而,个体特征和情况的变化与生活质量变化的关联并不像预期的那么紧密,这表明有效干预可能很困难。