Bankole Azziza O, Cohen Carl I, Vahia Ipsit, Diwan Shilpa, Kehn Michelle, Ramirez Paul M
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
Am J Geriatr Psychiatry. 2007 Dec;15(12):1015-23. doi: 10.1097/JGP.0b013e31805d8572.
There have been few studies of quality of life (QOL) among older persons with schizophrenia. The authors used an adaptation of Lehman's QOL model to examine factors that impact QOL in a multiracial urban sample of older persons with schizophrenia.
The schizophrenia group consisted of 198 community-dwelling persons aged 55 years and older who developed schizophrenia before age 45 years. A community comparison group (N = 113) was recruited using randomly selected block-groups. The QOL model consisted of four variable sets (demographic, objective, clinical, and subjective) comprising 19 independent variables. The dependent variable was the Quality of Life Index (QLI).
The schizophrenia group had a significantly lower QLI score than the comparison group (21.7 versus 24.2; t = -5.36, df = 362, p = 0.001). Within the schizophrenia group, in bivariate analyses, 11 of 19 variables were significantly related to QLI. In regression analysis, six variables were significantly associated with the QLI: fewer depressive symptoms, more cognitive deficits, fewer acute life stressors, fewer medication side effects, lower financial strain, and better self-rated health. The model explained 55% of the variance in QLI, with the demographic, objective, psychiatric illness, and subjective variable sets accounting for 6%, 35%, 9%, and 5% of the variance, respectively. With the exception of the demographic set, each of the variable sets added significant variance.
Our data confirmed earlier reports that older persons with schizophrenia have lower self-reported quality of life than their age-matched peers. Our findings suggest that the factors impacting on QOL are potentially ameliorable and therefore provide an opportunity to enhance the well-being of this population.
关于老年精神分裂症患者生活质量(QOL)的研究较少。作者采用莱曼生活质量模型的改编版,以研究在一个多民族城市老年精神分裂症患者样本中影响生活质量的因素。
精神分裂症组由198名年龄在55岁及以上、45岁之前患上精神分裂症的社区居住者组成。使用随机选择的街区组招募了一个社区对照组(N = 113)。生活质量模型由四个变量集(人口统计学、客观、临床和主观)组成,包含19个自变量。因变量是生活质量指数(QLI)。
精神分裂症组的QLI得分显著低于对照组(21.7对24.2;t = -5.36,自由度 = 362,p = 0.001)。在精神分裂症组内,在双变量分析中,19个变量中有11个与QLI显著相关。在回归分析中,六个变量与QLI显著相关:抑郁症状较少、认知缺陷较多、急性生活应激源较少、药物副作用较少、经济压力较低以及自评健康状况较好。该模型解释了QLI变异的55%,人口统计学、客观、精神疾病和主观变量集分别占变异的6%、35%、9%和5%。除人口统计学变量集外,每个变量集都增加了显著的变异。
我们的数据证实了早期的报告,即老年精神分裂症患者自我报告的生活质量低于与其年龄匹配的同龄人。我们的研究结果表明,影响生活质量的因素可能是可以改善的,因此为提高这一人群的福祉提供了机会。