Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong.
Psychiatry Res. 2017 Mar;249:39-45. doi: 10.1016/j.psychres.2016.12.038. Epub 2016 Dec 27.
Subjective quality of life (SQoL) has been increasingly studied in first-episode psychosis (FEP). Prior research primarily examined the impact of psychiatric symptoms on SQoL. Relationship between treatment-related factors and SQoL is under-studied. In this study, 159 Chinese patients who had completed 2-year treatment from early intervention service in Hong Kong were recruited. Assessments on premorbid adjustment, clinical profiles including social anxiety measure, functioning, antipsychotic-induced extrapyramidal side-effects and attitude toward medication treatment were conducted. SQoL was evaluated by Chinese version SF36 which generated mental and physical component summary (MCS and PCS) scores for analysis. Our results showed that more severe positive symptoms, higher level of depression, greater social anxiety, more negative attitude toward antipsychotic medications and greater degree of akathisia independently predicted lower MCS score. Higher social anxiety level and poorer functioning predicted lower PCS score. Our results indicate that affective and positive symptoms, functioning, and treatment-related variables are critical determinants of SQoL in FEP patients. These identified factors thus represent potentially malleable therapeutic targets for early detection and prompt intervention to promote enhancement of SQoL in the early stage of illness.
主观生活质量（SQoL）在首发精神病（FEP）中越来越受到研究关注。先前的研究主要考察了精神症状对 SQoL 的影响。而治疗相关因素与 SQoL 之间的关系则研究较少。本研究招募了 159 名来自香港早期干预服务的完成 2 年治疗的中国患者。评估了病前适应情况、临床特征（包括社交焦虑量表）、功能、抗精神病药引起的锥体外系副作用和对药物治疗的态度。通过中文版 SF36 评估 SQoL，该量表生成了心理和生理成分综合评分（MCS 和 PCS）进行分析。我们的结果表明，更严重的阳性症状、更高的抑郁水平、更大的社交焦虑、对抗精神病药物的负面态度以及更大的静坐不能程度独立预测 MCS 评分较低。更高的社交焦虑水平和较差的功能预测 PCS 评分较低。我们的研究结果表明，情感和阳性症状、功能以及治疗相关变量是 FEP 患者 SQoL 的关键决定因素。因此，这些确定的因素代表了早期发现和及时干预的潜在可改变的治疗目标，以在疾病早期促进 SQoL 的提高。
