Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Psychiatry Res. 2011 Sep 30;189(2):185-9. doi: 10.1016/j.psychres.2011.02.017. Epub 2011 Mar 30.
Depression in schizophrenia has been recognized as one of the important factors influencing the Quality of Life (QOL). For this study 60 patients with a clinical diagnosis of schizophrenia as per ICD-10 (DCR version) were divided into two groups (with and without depression) on the basis of their score on Calgary Depression Rating Scale for Schizophrenia (CDSS). Thereafter, all patients were assessed on Positive and Negative Syndrome Scale for Schizophrenia (PANSS) for psychopathology, on Lehman Quality of Life Interview (QOLI)-brief version for QOL, on World Health Organization Disability Assessment Schedule-II (WHODAS-II) for disability, on UKU Side Effect Rating Scale for side effects of drugs and on Social Support Questionnaire (SSQ) for perceived social support. The two (depressed and non-depressed schizophrenia) groups differed significantly on symptoms of general psychopathology of PANSS and disability as per WHODAS-II, with the depressed group scoring higher. In the total sample, positive symptoms and the symptoms of general psychopathology of PANSS had a strong negative correlation with all three (subjective, objective and combined) domains of QOL, whereas, disability and medication side effects had a negative correlation with subjective and combined domains of QOL. CDSS total score did not significantly correlate with QOL. General psychopathology symptoms of PANSS emerged as the sole significant predictor of subjective and combined QOL, while positive symptoms of PANSS emerged as the sole predictor of objective QOL. Hence, it can be concluded that general psychopathology on PANSS had significant effect whereas depression as rated on CDSS had no significant effect on QOL in patients with schizophrenia. Treatments to improve QOL in schizophrenia should focus on symptoms of general psychopathology of PANSS.
精神分裂症中的抑郁已被认为是影响生活质量（QOL）的重要因素之一。为此，本研究根据 Calgary 精神分裂症抑郁评定量表（CDSS）的评分，将 60 名符合 ICD-10（DCR 版）临床诊断的精神分裂症患者分为两组（有抑郁和无抑郁）。此后，所有患者均接受精神分裂症阳性和阴性症状量表（PANSS）评估精神病理学、简明版 Lehman 生活质量访谈（QOLI）评估生活质量、世界卫生组织残疾评估量表-II（WHODAS-II）评估残疾、UKU 药物副作用评定量表评估药物副作用以及社会支持问卷（SSQ）评估感知社会支持。抑郁和非抑郁精神分裂症两组在 PANSS 一般精神病理学症状和 WHODAS-II 残疾方面存在显著差异，抑郁组得分更高。在总样本中，阳性症状和 PANSS 一般精神病理学症状与生活质量的所有三个（主观、客观和综合）领域均呈强烈负相关，而残疾和药物副作用与主观和综合领域均呈负相关。CDSS 总分与 QOL 无显著相关性。PANSS 的一般精神病理学症状是主观和综合 QOL 的唯一显著预测因素，而 PANSS 的阳性症状是客观 QOL 的唯一预测因素。因此，可以得出结论，PANSS 的一般精神病理学症状对精神分裂症患者的 QOL 有显著影响，而 CDSS 评定的抑郁则无显著影响。改善精神分裂症 QOL 的治疗应侧重于 PANSS 的一般精神病理学症状。
