Research Division, Institute of Mental Health/Woodbridge Hospital, Singapore.
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Apr 16;34(3):463-8. doi: 10.1016/j.pnpbp.2010.01.014. Epub 2010 Jan 25.
Quality of life (QOL) impairment is evident in patients with schizophrenia and is increasingly recognised as an important evaluation criterion of treatment outcome. Hence, this study aimed to identify the neurocognitive, clinical and functional parameters associated with subjective QOL in patients with schizophrenia within an Asian context, and specifically in an outpatient setting. This study was conducted on 83 outpatients with DSM-IV diagnosis of schizophrenia, and 47 age- and gender-matched healthy controls. All participants were administered with the World Health Organisation Quality of Life Assessment-Brief Form (WHOQOL-BREF) and Brief Assessment of Cognition in Schizophrenia (BACS), to measure quality of life and cognitive function respectively. Patients were also assessed for severity of psychopathology, as well as level of psychosocial functioning, using the Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) rating scales respectively. Specific psychopathology (greater severity of PANSS negative symptoms, general psychopathology subscale scores), cognitive deficits (working and verbal memories), and lower GAF scores were correlated with poorer QOL in patients. Multivariate analyses revealed that younger age, being single and lower level of psychosocial functioning were associated with poorer QOL but level of psychosocial functioning did not appear to mediate the effects of symptoms and neurocognitive deficits on QOL. Overall, this study highlighted the need for clinicians to pay more attention to these clinical, neurocognitive and functional parameters and their integrative relationships with QOL in order to optimise the treatment outcomes of patients with schizophrenia.
生活质量(QOL)受损在精神分裂症患者中很明显,并且越来越被认为是治疗结果的重要评估标准。因此,本研究旨在确定与亚洲背景下(特别是在门诊环境中)精神分裂症患者主观 QOL 相关的神经认知、临床和功能参数。本研究纳入了 83 名 DSM-IV 诊断为精神分裂症的门诊患者和 47 名年龄和性别匹配的健康对照者。所有参与者均接受了世界卫生组织生活质量评估-简短形式(WHOQOL-BREF)和简明精神分裂症认知评估(BACS)的评估,分别用于评估生活质量和认知功能。患者还分别使用阳性和阴性症状量表(PANSS)和总体功能评估量表(GAF)评估精神病理学严重程度和心理社会功能水平。特定的精神病理学(更严重的 PANSS 阴性症状、一般精神病学量表评分)、认知缺陷(工作和言语记忆)以及较低的 GAF 评分与患者较差的 QOL 相关。多变量分析显示,年龄较小、单身和较低的心理社会功能水平与较差的 QOL 相关,但心理社会功能水平似乎并未介导症状和神经认知缺陷对 QOL 的影响。总体而言,本研究强调临床医生需要更加关注这些临床、神经认知和功能参数及其与 QOL 的综合关系,以优化精神分裂症患者的治疗效果。