Savill M, Orfanos S, Reininghaus U, Wykes T, Bentall R, Priebe S
Unit for Social and Community Psychiatry, WHO Collaborative Centre for Mental Health Services Development, Queen Mary University of London, London E13 8SP, United Kingdom.
Institute of Psychiatry, Kings College London, De Crespigny Park, London SE5 8AF, United Kingdom; Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands.
Schizophr Res. 2016 Oct;176(2-3):387-391. doi: 10.1016/j.schres.2016.06.017. Epub 2016 Jun 18.
Understanding the link between quality of life and symptoms in schizophrenia is important in enhancing the prospect of patient recovery. Only weak associations have been found between subjective quality of life (SQOL) and negative symptoms. However, this may be because many existing symptom assessment scales inadequately assess the experiential deficits of negative symptoms. This study aimed to re-evaluate these findings using the Clinical Assessment Interview for Negative Symptoms (CAINS), which as been designed to capture both the expressive and experiential subdomains of negative symptoms as separate constructs. In this observational study 275 participants with at least moderate negative symptoms were assessed three times over nine months using the CAINS, the Positive and Negative Syndrome Scale (PANSS), and the Manchester Short Assessment of Quality of Life (MANSA). A significant negative association between SQOL and the CAINS experiential subscale was found in the cross-sectional analysis (adj. B=-0.28, 95% CI=-0.44 to -0.12, P=0.001), and in the change scores (adj. B=-0.13, 95% CI=-0.26 to -0.01, P=0.032). No associations between SQOL and expressive symptoms, or negative symptoms measured using the PANSS were detected in the multivariable models. These findings suggest that the association between negative symptoms and SQOL is related primarily to experiential deficits, and highlights the importance of measuring the separate subdomains of negative symptoms as distinct constructs. The findings also highlight the impact of negative symptoms and experiential deficits in particular on social outcomes, further emphasising the need to develop new treatments for these symptoms.
了解精神分裂症患者生活质量与症状之间的联系对于提高患者康复的可能性至关重要。目前仅发现主观生活质量（SQOL）与阴性症状之间存在微弱关联。然而，这可能是因为许多现有的症状评估量表对阴性症状的体验性缺陷评估不足。本研究旨在使用阴性症状临床评估访谈（CAINS）重新评估这些发现，该访谈旨在将阴性症状的表达性和体验性子领域作为单独的结构进行评估。在这项观察性研究中，275名至少有中度阴性症状的参与者在九个月内使用CAINS、阳性和阴性症状量表（PANSS）以及曼彻斯特生活质量简短评估（MANSA）进行了三次评估。在横断面分析中发现SQOL与CAINS体验性子量表之间存在显著负相关（调整后B=-0.28，95%CI=-0.44至-0.12，P=0.001），在变化分数中也存在显著负相关（调整后B=-0.13，95%CI=-0.26至-0.01，P=0.032）。在多变量模型中未检测到SQOL与表达性症状或使用PANSS测量的阴性症状之间的关联。这些发现表明，阴性症状与SQOL之间的关联主要与体验性缺陷有关，并强调了将阴性症状的各个子领域作为不同结构进行测量的重要性。研究结果还突出了阴性症状尤其是体验性缺陷对社会结局的影响，进一步强调了开发针对这些症状的新治疗方法的必要性。
