Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
Nursing Department, Universitat Rovira i Vigili, Tarragona, Spain.
Early Interv Psychiatry. 2019 Dec;13(6):1447-1454. doi: 10.1111/eip.12791. Epub 2019 Jan 28.
Quality of life (QoL) and social functioning have emerged as good predictors of the outcome of psychotic disorders. Poor QoL and social functioning are usually present before the onset of the first episode of psychosis. Our study aimed to explore the relationship between social adaptation and QoL in young people at risk of psychosis (ultra-high-risk, UHR) and healthy controls (HCs), and to investigate potential mediating effects of stress measures (perceived stress, stressful life events).
The study included 55 UHR subjects and 40 HC. Social functioning was assessed with the Social Adaptation Self-evaluation Scale (SASS). Stress measures included the assessment of stressful life events and perceived stress. We compared stress and QoL measures between UHR and HC, and also compared UHR with low or normal social adaptation. A mediation analysis was performed to explore whether stress measures mediated the relationship between social adaptation and QoL.
UHR were less frequently employed and reported more stress, poorer QoL and lower social adaptation than HC. QoL and social adaptation were associated with stress measures. UHR with low social adaptation reported more perceived stress and less QoL than UHR with normal social adaptation and HC. Perceived stress mediated the relationship between social adaptation and QoL.
Social adaptation is less developed in UHR subjects than in healthy subjects and has a negative impact on quality of life. This association is mediated by perceived stress.
生活质量（QoL）和社会功能已成为精神障碍预后的良好预测指标。在精神病首次发作之前，通常存在生活质量和社会功能较差的情况。我们的研究旨在探讨处于精神病高危状态（超高危，UHR）的年轻人与健康对照者（HC）之间的社会适应与生活质量之间的关系，并研究应激测量指标（感知压力、生活应激事件）的潜在中介作用。
本研究纳入了 55 名 UHR 受试者和 40 名 HC。采用社会适应自评量表（SASS）评估社会功能。应激测量指标包括生活应激事件和感知压力的评估。我们比较了 UHR 和 HC 之间的应激和 QoL 指标，以及 UHR 中社会适应程度较低或正常的个体之间的差异。进行中介分析以探讨应激测量指标是否在社会适应和 QoL 之间的关系中起中介作用。
与 HC 相比，UHR 的就业率较低，报告的压力更大、生活质量更差、社会适应度更低。QoL 和社会适应度与应激测量指标相关。社会适应度较低的 UHR 报告的感知压力更高，生活质量更差，而正常社会适应度的 UHR 和 HC 则报告的感知压力更低，生活质量更高。感知压力在社会适应和 QoL 之间的关系中起中介作用。
与健康对照者相比，UHR 受试者的社会适应度较差，这对生活质量产生负面影响。这种关联是由感知压力介导的。
