Ritsner Michael S, Arbitman Marina, Lisker Alexander
Department of Psychiatry, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
J Nerv Ment Dis. 2011 Nov;199(11):845-53. doi: 10.1097/NMD.0b013e3182349ce6.
The aim of the current study was to investigate an association of physical and social hedonic deficits with health-related quality of life (HRQL), controlling for related distressing and protective factors. Eighty-seven stable patients with schizophrenia (SZ) and schizoaffective disorder (SA) were assessed using the revised Physical Anhedonia Scale (PAS) and the Social Anhedonia Scale (SAS), the Quality of Life Enjoyment and Life Satisfaction Questionnaire (Q-LES-Q), and related factors. Hedonic and HRQL deficit scores did not reach significant differences between SZ and SA patients. General and domain-specific Q-LES-Q scores were significantly correlated with PAS and SAS scores independent of the adverse effects and psychopathological symptoms. Dissatisfaction with HRQL increased from "normal hedonics" (4.8%) to "hypohedonics" (28.6%) and "double anhedonics" (66.7%). Permanently dissatisfied patients who revealed deterioration in general quality of life across 10 years had significantly higher PAS and SAS scores than did patients who were permanently satisfied and improved. An exploratory factor analysis yielded a three-factor solution; PAS and SAS scores were joined to the second factor together with Q-LES-Q, self-efficacy, coping styles, and social support scores. PAS scores accounted for 7% to 13% of the total variance in three domains and in the general quality-of-life alterations. SAS scores did not predict variability in the Q-LES-Q domains. Therefore, physical and social hedonic deficits significantly associated with poor HRQL independent of the adverse effects and psychopathological symptoms of SZ/SA. Physical anhedonia may be a predictor for quality-of-life deficit.
本研究的目的是调查身体和社交享乐缺陷与健康相关生活质量（HRQL）之间的关联，并控制相关的困扰因素和保护因素。使用修订后的身体快感缺乏量表（PAS）、社交快感缺乏量表（SAS）、生活质量享受与生活满意度问卷（Q-LES-Q）及相关因素对87例稳定的精神分裂症（SZ）和分裂情感性障碍（SA）患者进行评估。SZ和SA患者之间的享乐和HRQL缺陷得分没有显著差异。一般和特定领域的Q-LES-Q得分与PAS和SAS得分显著相关，且不受不良反应和精神病理症状的影响。对HRQL的不满从“正常享乐”（4.8%）增加到“快感缺乏”（28.6%）和“双重快感缺乏”（66.7%）。在10年中总体生活质量出现恶化的永久不满意患者的PAS和SAS得分显著高于永久满意且病情改善的患者。探索性因素分析得出一个三因素解决方案；PAS和SAS得分与Q-LES-Q、自我效能感、应对方式和社会支持得分一起归入第二个因素。PAS得分在三个领域和总体生活质量改变的总方差中占7%至13%。SAS得分不能预测Q-LES-Q各领域的变异性。因此，身体和社交享乐缺陷与较差的HRQL显著相关，且不受SZ/SA的不良反应和精神病理症状的影响。身体快感缺乏可能是生活质量缺陷的一个预测指标。
