Hayhurst Karen P, Massie Jennifer A, Dunn Graham, Lewis Shôn W, Drake Richard J
Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, UK.
Laureate House Mental Health Unit, Manchester Mental Health & Social Care Trust, Wythenshawe Hospital, Southmoor Road, Manchester, UK.
BMC Psychiatry. 2014 Dec 24;14:365. doi: 10.1186/s12888-014-0365-x.
Quality of life (QoL) is considered an important outcome in health research. It can be rated by the patient, or by an external assessor. We wished to identify the predictors of any discrepancies between these two approaches in people with schizophrenia.
Patients with DSM schizophrenia and related disorders (N = 80) completed both patient-rated (Lancashire Quality of Life Profile; LQOLP) and assessor-rated (Heinrich's Quality of Life Scale; QLS) measures of QoL.
Patient-rated (LQOLP) and assessor-rated (QLS) measures showed a modest correlation (r = 0.38). In a regression analysis, independent predictors of subjectively-rated QoL being higher than objectively-assessed QoL in the same patient, were low insight score (BIS), negative symptoms (PANSS), absence of depression (CDSS), and less positive attitude toward prescribed treatment (DAI).
In people with schizophrenia, scores on objectively- and subjectively-rated measures of quality of life can differ markedly. When comparing subjective to objective assessments, patients with depressive symptoms will value their QoL lower, and those with low insight will value their QoL higher. This has important implications for the utility and interpretation of QoL measures in schizophrenia.
生活质量（QoL）被认为是健康研究中的一项重要成果。它可以由患者自评，也可由外部评估者评定。我们希望确定精神分裂症患者这两种评定方法之间存在差异的预测因素。
80例患有DSM精神分裂症及相关障碍的患者完成了患者自评（兰开夏生活质量量表；LQOLP）和评估者评定（海因里希生活质量量表；QLS）的生活质量测评。
患者自评（LQOLP）和评估者评定（QLS）测评显示出适度的相关性（r = 0.38）。在一项回归分析中，同一患者主观评定的生活质量高于客观评定的生活质量的独立预测因素为自知力得分低（BIS）、阴性症状（PANSS）、无抑郁（CDSS）以及对规定治疗的积极态度较低（DAI）。
在精神分裂症患者中，客观评定和主观评定的生活质量得分可能存在显著差异。在比较主观评估与客观评估时，有抑郁症状的患者对其生活质量的评价较低，而自知力低的患者对其生活质量的评价较高。这对精神分裂症生活质量测评的效用和解读具有重要意义。
