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精神分裂症患者总体生活质量的预测因素及健康相关生活质量的中介作用。

Predictors of general quality of life and the mediating role of health related quality of life in patients with schizophrenia.

作者信息

Meijer Carin J, Koeter Maarten W J, Sprangers Mirjam A G, Schene Aart H

机构信息

Dept. of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2009 May;44(5):361-8. doi: 10.1007/s00127-008-0448-4. Epub 2008 Oct 30.

Abstract

INTRODUCTION

The concept 'quality of life' (QoL) has become increasingly important as an outcome measure in the evaluation of services and in clinical trials of people with schizophrenia. This study examines the mediating role of health related quality of life (HRQoL) in the prediction of general quality of life (GQoL).

METHOD

QoL and other patient- and illness characteristics (psychopathology, overall functioning, illness history, self-esteem and social integration) were measured in a group of 143 outpatients with schizophrenia. GQoL was measured by the Lancashire Quality of Life Profile and HRQoL was measured by the MOS SF-36. To test the temporal stability of our findings, assessments were performed twice with an 18-month interval.

RESULTS

We found that patient's GQoL is predicted mainly by anxiety and depression and self-esteem and to a lesser extent by global functioning and social integration. At both time intervals HRQoL appeared to be a significant mediator of the relationship between anxiety and depression and self esteem versus patient's GQoL.

CONCLUSIONS

The results of this study are important for mental health professionals, as these provide more insight in the mechanisms by which they could improve the GQoL of their patients with schizophrenia. The results confirm that diagnosis and treatment of anxiety and depression in outpatients with schizophrenia deserves careful attention of clinicians. Also strategies and specific interventions to improve self-esteem of patients with schizophrenia are very important to maximise patient's QoL.

摘要

引言

“生活质量”(QoL)这一概念在评估服务以及精神分裂症患者的临床试验中作为一项结果指标变得越来越重要。本研究考察了健康相关生活质量(HRQoL)在预测总体生活质量(GQoL)中的中介作用。

方法

对143名精神分裂症门诊患者测量了生活质量以及其他患者和疾病特征(精神病理学、整体功能、疾病史、自尊和社会融合)。GQoL通过兰开夏生活质量量表进行测量,HRQoL通过医学结局研究简明健康调查(MOS SF - 36)进行测量。为了检验我们研究结果的时间稳定性,间隔18个月进行了两次评估。

结果

我们发现患者的GQoL主要由焦虑、抑郁和自尊预测,在较小程度上由整体功能和社会融合预测。在两个时间间隔中,HRQoL似乎都是焦虑、抑郁和自尊与患者GQoL之间关系的显著中介。

结论

本研究结果对心理健康专业人员很重要,因为这些结果能让他们更深入了解改善精神分裂症患者GQoL的机制。结果证实,精神分裂症门诊患者焦虑和抑郁的诊断与治疗值得临床医生密切关注。此外,提高精神分裂症患者自尊的策略和具体干预措施对于最大化患者的生活质量非常重要。

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