Gardsjord Erlend Strand, Romm Kristin Lie, Friis Svein, Barder Helene Eidsmo, Evensen Julie, Haahr Ulrik, ten Velden Hegelstad Wenche, Joa Inge, Johannessen Jan Olav, Langeveld Johannes, Larsen Tor Ketil, Opjordsmoen Stein, Rund Bjørn Rishovd, Simonsen Erik, Vaglum Per, McGlashan Thomas, Melle Ingrid, Røssberg Jan Ivar
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway.
Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway.
Schizophr Res. 2016 Apr;172(1-3):23-8. doi: 10.1016/j.schres.2016.02.034. Epub 2016 Mar 2.
Subjective quality of life (S-QoL) is an important outcome measure in first episode psychosis (FEP). The aims of this study were to describe S-QoL-development the first 10-years in FEP patients and to identify predictors of this development.
A representative sample of 272 patients with a first episode psychotic disorder was included from 1997 through 2000. At 10 year follow-up 186 patients participated. QoL was measured by the Lehman's Quality of Life Interview. Linear mixed model analyses were performed to investigate longitudinal effects of baseline psychiatric symptoms and socio-economic variables and the effects of changes in the same variables on S-QoL-development.
S-QoL improved significantly over the follow-up period. More contact with family and a better financial situation at baseline had a positive and longstanding effect on S-QoL-development, but changes in these variables were not associated with S-QoL-development. Higher depressive symptoms and less daily activities at baseline both had a negative independent effect, but a positive interaction effect with time on S-QoL-development indicating that the independent negative effect diminished over time. In the change analysis, increased daily activities and a decrease in depressive symptoms were associated with a positive S-QoL-development.
Treatment of depressive symptoms and measures aimed at increasing daily activities seem important to improve S-QoL in patients with psychosis. More contact with family and a better financial situation at baseline have a long-standing effect on S-QoL-development in FEP patients.
主观生活质量（S-QoL）是首发精神病（FEP）的一项重要结局指标。本研究的目的是描述FEP患者最初10年的S-QoL发展情况，并确定该发展的预测因素。
纳入了1997年至2000年期间272例首发精神障碍患者的代表性样本。在10年随访时，有186例患者参与。生活质量通过雷曼生活质量访谈进行测量。进行线性混合模型分析，以研究基线精神症状和社会经济变量的纵向影响，以及相同变量的变化对S-QoL发展的影响。
在随访期间，S-QoL有显著改善。基线时与家人更多的接触和更好的经济状况对S-QoL发展有积极且持久的影响，但这些变量的变化与S-QoL发展无关。基线时较高的抑郁症状和较少的日常活动均有独立的负面影响，但对S-QoL发展与时间有正向交互作用表明独立的负面影响随时间减弱。在变化分析中，日常活动增加和抑郁症状减轻与S-QoL的正向发展相关。
治疗抑郁症状以及旨在增加日常活动的措施似乎对改善精神病患者的S-QoL很重要。基线时与家人更多的接触和更好的经济状况对FEP患者的S-QoL发展有长期影响。
