Tomotake Masahito
Department of Mental Health, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2011 Aug;58(3-4):167-74. doi: 10.2152/jmi.58.167.
The author reviewed measurement of quality of life (QOL) of schizophrenia patients and the clinical factors related to their QOL. As schizophrenia patients were thought to be unable to assess their own QOL because of their cognitive impairment, objective QOL measures had been frequently used. However, nowadays, there is general agreement that symptomatically stabilized patients could assess their QOL by themselves. Therefore, researchers gradually have become interested in subjective QOL measure. Although most researchers often evaluate schizophrenia patients' QOL using only subjective or objective QOL measure, considering the fact that there is a discrepancy between the two types of measures, it is recommended to use both of them as complementary measures. As for clinical factors related to lowered QOL, several studies reported that depressive symptom was most associated with lowered subjective QOL, negative symptom was strongly related to lowered objective one and poor life skill was associated with both. Moreover, several studies found that cognitive dysfunctions in some cognitive domains were related to lowered objective QOL but the effects of them were much smaller than those of negative symptoms. It is suggested that improving depressive and negative symptoms and life skills may contribute to enhancement of QOL of schizophrenia patients.
作者回顾了精神分裂症患者生活质量（QOL）的测量方法以及与其QOL相关的临床因素。由于精神分裂症患者被认为因认知障碍而无法评估自身的QOL，因此客观QOL测量方法经常被使用。然而，如今人们普遍认为症状稳定的患者能够自行评估其QOL。因此，研究人员逐渐对主观QOL测量方法产生了兴趣。尽管大多数研究人员通常仅使用主观或客观QOL测量方法来评估精神分裂症患者的QOL，但考虑到这两种测量方法之间存在差异，建议将两者作为互补测量方法同时使用。至于与QOL降低相关的临床因素，多项研究报告称，抑郁症状与主观QOL降低最为相关，阴性症状与客观QOL降低密切相关，而生活技能差与两者均有关联。此外，多项研究发现，某些认知领域的认知功能障碍与客观QOL降低有关，但其影响远小于阴性症状。研究表明，改善抑郁和阴性症状以及生活技能可能有助于提高精神分裂症患者的QOL。
