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I型双相情感障碍和缓解期精神分裂症的生活质量:临床和神经认知相关性

Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates.

作者信息

Brissos Sofia, Dias Vasco Videira, Carita Ana Isabel, Martinez-Arán Anabel

机构信息

Júlio de Matos' Psychiatric Hospital, Lisbon, Portugal.

出版信息

Psychiatry Res. 2008 Jul 15;160(1):55-62. doi: 10.1016/j.psychres.2007.04.010. Epub 2008 May 15.

Abstract

This cross-sectional study examined the relationships between clinical and neuropsychological variables and self-reported quality of life (QoL) in 30 euthymic bipolar I patients, 23 remitted schizophrenic patients, and 23 healthy controls. Participants were administered the World Health Organization Quality of Life Measure-Abbreviated Version (WHOQOL-BREF) to assess QoL. Moreover, a broad neuropsychological battery was also administered. Bipolar disorder (BD) and schizophrenia patients demonstrated significantly lower scores on the physical, psychological, and social domains of the WHOQOL-BREF compared with controls, but there were no significant differences between the two patient groups on those domains. More symptomatic BD patients reported worse QoL, especially in the physical and environmental domains, which was also associated with worse neurocognitive performance. In schizophrenic patients, neurocognitive performance was not associated with self-reported QoL, but more symptomatic patients reported lower QoL. Substantial impairments in QoL, similar in severity, were found in both patient groups. In patients with schizophrenia, QoL was more strongly related to levels of psychopathology, whereas in BD patients, both psychopathology and neurocognitive deficits were strongly associated with lower QoL. Clinical recovery is essential in schizophrenia and BD. The association between cognitive functioning and QoL in bipolar patients suggests that these patients may also benefit from psychological interventions addressed to improve cognitive deficits and enhance the functional recovery.

摘要

这项横断面研究考察了30名处于双相情感障碍I型缓解期的患者、23名精神分裂症缓解期患者和23名健康对照者的临床及神经心理学变量与自我报告的生活质量(QoL)之间的关系。研究人员让参与者接受了世界卫生组织生活质量简表(WHOQOL - BREF)以评估生活质量。此外,还进行了一系列广泛的神经心理学测试。与对照组相比,双相情感障碍(BD)患者和精神分裂症患者在WHOQOL - BREF的生理、心理和社会领域得分显著更低,但两组患者在这些领域上没有显著差异。症状更明显的BD患者报告的生活质量更差,尤其是在生理和环境领域,这也与较差的神经认知表现相关。在精神分裂症患者中,神经认知表现与自我报告的生活质量无关,但症状更明显的患者报告的生活质量更低。两组患者均存在严重程度相似的生活质量显著受损情况。在精神分裂症患者中,生活质量与精神病理学水平的关联更强,而在BD患者中,精神病理学和神经认知缺陷均与较低的生活质量密切相关。临床康复对精神分裂症和双相情感障碍患者至关重要。双相情感障碍患者认知功能与生活质量之间的关联表明,这些患者可能也会从旨在改善认知缺陷和促进功能恢复的心理干预中受益。

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