Universitat de Barcelona, Barcelona, Spain.
Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2018 Mar;53(3):239-248. doi: 10.1007/s00127-018-1483-4. Epub 2018 Jan 16.
The objective of this study was to analyze the clinical factors associated with changes in HRQoL in outpatients with schizophrenia using both generic and condition-specific HRQoL scales.
Adult outpatients with schizophrenia at least 18 years of age who did not have an acute psychotic exacerbation in the 3 months prior to baseline were recruited. PANSS dimensions were calculated based on Lindenmayer et al.'s five factors. HRQoL data were assessed by patients using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D) questionnaires.
Out of the 1345 patients included at baseline, 1196 (89%) were evaluated at 12 months. Regression models showed that the factor most consistently associated with HRQoL at endpoint was change in the PANSS negative symptoms score. A decrease in the PANSS negative symptoms score from baseline to 1 year was associated with a decrease in HRQoL during the same period. There were also significant associations of the change in PANSS excitatory factor with all the HRQoL scales except the SF-36 PCS. Female gender was associated with a decrease in all HRQoL ratings. There was also a relationship between years since onset and HRQoL. The longer the time since illness onset, the larger the decrease in HRQoL.
This study has found that, in outpatients with schizophrenia, changes in negative and excitement symptoms may have a greater an association with HRQoL than changes in positive, cognitive and depressive symptoms.
本研究旨在使用通用和特定疾病的健康相关生活质量（HRQoL）量表分析门诊精神分裂症患者 HRQoL 变化的相关临床因素。
招募至少 18 岁、基线前 3 个月内无急性精神病恶化的成年门诊精神分裂症患者。根据 Lindenmayer 等人的五因素计算 PANSS 维度。患者使用精神分裂症生活质量量表（SQLS）、短式健康调查问卷 36 项（SF-36）和欧洲五维健康量表（EQ-5D）评估 HRQoL 数据。
在基线时纳入的 1345 例患者中，有 1196 例（89%）在 12 个月时进行了评估。回归模型显示，与终点 HRQoL 最一致相关的因素是 PANSS 阴性症状评分的变化。从基线到 1 年 PANSS 阴性症状评分的下降与同期 HRQoL 的下降相关。PANSS 兴奋因子的变化与除 SF-36 PCS 之外的所有 HRQoL 量表也存在显著关联。女性性别与所有 HRQoL 评分的下降相关。发病时间与 HRQoL 之间也存在关系。发病时间越长，HRQoL 的下降幅度越大。
本研究发现，在门诊精神分裂症患者中，阴性和兴奋症状的变化与 HRQoL 的相关性可能大于阳性、认知和抑郁症状的变化。
