Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Judd Hall, 207 High Street, Middletown, CT 06549, USA.
Schizophr Bull. 2012 Mar;38(2):304-15. doi: 10.1093/schbul/sbq077. Epub 2010 Jul 11.
Quality of life (QOL) has been recognized as a crucial domain of outcome in schizophrenia treatment, and yet its determinants are not well understood. Recent meta-analyses suggest that symptoms have only a modest relationship to QOL (Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007;33:1225-1237). Individuals with schizophrenia show 1-2 SD deficits on measures of elementary neurocognition, and links between these deficits and objective measures of community functioning (eg, employment and independent living) are well established. While objective measures of community functioning and measures of QOL would appear to be closely related, studies investigating the ability of neurocognitive variables to predict QOL in individuals with schizophrenia have yielded conflicting results. One potential explanation for opposing findings in the schizophrenia literature is the interchangeable use of objective and subjective indices of QOL. This study used quantitative methods of meta-analysis to clarify the relationship between neurocognitive determinants of objective QOL (ie, observable, clinician-rated) and subjective QOL (ie, patient satisfaction) separately in individuals with schizophrenia. A total of 20 studies (10 objective and 10 subjective) consisting of 1615 clients were aggregated from relevant databases. Weighted effect size analysis revealed that there were small-moderate relationships (d ≤ 0.55) between crystallized verbal ability, working memory verbal list learning, processing speed, and executive function and objective indices of QOL. In contrast, results revealed either nonsignificant or inverse relationships for the vast majority of neurocognitive measures and measures of subjective QOL. Moderating variables and implications for future research and treatment development are discussed.
生活质量 (QOL) 已被认为是精神分裂症治疗结果的关键领域，但它的决定因素还不是很清楚。最近的荟萃分析表明，症状与 QOL 只有适度的关系（Eack SM，Newhill CE。精神病症状和精神分裂症的生活质量：荟萃分析。Schizophr Bull。2007;33:1225-1237）。精神分裂症患者在基本神经认知方面表现出 1-2 个标准差的缺陷，这些缺陷与客观的社区功能（如就业和独立生活）之间的联系已得到充分证实。虽然社区功能的客观测量和 QOL 的测量似乎密切相关，但研究神经认知变量对精神分裂症患者的 QOL 的预测能力的研究结果却相互矛盾。精神分裂症文献中出现相反结果的一个潜在解释是客观和主观的 QOL 指标的可互换使用。这项研究使用荟萃分析的定量方法，分别在精神分裂症患者中阐明客观 QOL（即可观察的、临床评定的）和主观 QOL（即患者满意度）的神经认知决定因素之间的关系。从相关数据库中汇总了 20 项研究（10 项客观研究和 10 项主观研究），共 1615 名患者。加权效应大小分析表明，晶体语言能力、工作记忆言语列表学习、加工速度和执行功能与客观 QOL 指数之间存在小到中等的关系（d≤0.55）。相比之下，对于绝大多数神经认知测量和主观 QOL 测量，结果要么没有显著关系，要么呈反向关系。讨论了调节变量以及对未来研究和治疗发展的影响。
