Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, United Kingdom.
Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, United Kingdom.
Eur Psychiatry. 2014 Mar;29(3):191-6. doi: 10.1016/j.eurpsy.2013.03.002. Epub 2013 Jun 12.
Quality of life (QoL) is increasingly considered an important outcome in health research. We wished to explore the determinants of change in QoL in patients with schizophrenia over the course of a one-year RCT.
Predictors of change in observer-rated QoL (Quality of Life Scale: QLS) were assessed in 363 patients with schizophrenia during the CUtLASS clinical trial.
Change in QLS score over the course of a year correlated with change in psychotic and depressive symptoms and treatment adherence. Linear regression showed that improvement in QoL was predicted by reduction in negative and depressive symptoms and improvement in adherence rating. These three change scores together explained 38% of the variance in QLS change. Exploration of the direction of any possible causal effect, using TETRAD, indicated that improved adherence leads to improved QoL, and that change in depression also leads to QoL change. The relationship between QoL and negative symptoms suggests that greater social activity (reflected as better QoL scores) improves negative symptoms. Such a direct relationship between treatment adherence and QoL has not been reported before.
Improving adherence to medication would appear to be a key approach to improving measured quality of life in people with schizophrenia.
生活质量（QoL）越来越被认为是健康研究中的一个重要结果。我们希望探讨精神分裂症患者在一年 RCT 过程中 QoL 变化的决定因素。
在 CUtLASS 临床试验中，评估了 363 名精神分裂症患者的观察者评定 QoL（生活质量量表：QLS）变化的预测因素。
一年中 QLS 评分的变化与精神病和抑郁症状以及治疗依从性的变化相关。线性回归显示，QLS 改善的预测因素是阴性和抑郁症状的减轻以及依从性评分的提高。这三个变化分数共同解释了 QLS 变化的 38%。使用 TETRAD 探索任何可能的因果效应的方向表明，改善依从性可导致 QoL 改善，抑郁的变化也可导致 QoL 变化。QoL 和阴性症状之间的关系表明，更多的社会活动（表现为更好的 QoL 评分）可改善阴性症状。以前没有报告过治疗依从性和 QoL 之间的这种直接关系。
改善对药物的依从性似乎是改善精神分裂症患者生活质量的关键方法。
