Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
BMC Psychiatry. 2019 Sep 2;19(1):267. doi: 10.1186/s12888-019-2248-7.
The goal of clinicians and healthcare workers providing treatment to patients with psychiatric disorders, has shifted over time from focusing on the symptoms alone towards functional improvement. In this study, we aimed to compare the subjective quality of life (QoL) among patients with schizophrenia spectrum disorders and major depressive disorder (MDD).
QoL scores were collected using 36-item Short Form Survey Instrument. QoL scores were compared between 203 outpatients with schizophrenia spectrum disorders and 185 outpatients with MDD using analysis of covariance. The Positive and Negative Syndrome Scale was administered to assess the severity of psychiatric symptoms among patients with schizophrenia and Personal Health Questionnaire-8 items was utilized to assess the severity of depressive symptoms among patients with MDD. The correlation coefficient (r) of socio-demographic factors and core psychiatric symptoms with QoL were analyzed using multiple linear regression.
As compared to patients with MDD, patients with schizophrenia reported better health scores in all QoL subdomains, except for physical function (PF). Among patients with schizophrenia, old age was correlated with better mental health (MH, r = 0.35) and PF (r = 0.37). Compared to those of Chinese ethnicity, those of Malay, Indian and other ethnicity were correlated with worse PF (r = - 0.43 for Malays; r = - 0.30 for Indians and r = - 0.34 for other ethnicities). Longer duration of mental illness was correlated with worse MH (r = - 0.30), worse PF (r = - 0.38) and worse scores on role limitations due to physical health problems (RP, r = - 0.30). Among patients with MDD, older age was correlated with worse PF (r = - 0.33) and patients without comorbid physical illness reported less bodily pain (r = 0.45) and better general health (r = 0.34). Moreover, all psychiatric symptoms among patients with schizophrenia were negatively correlated with QoL, but the strength of the correlation was less than that between depressive symptoms and QoL among patients with MDD.
Patients with schizophrenia generally reported better QoL as compared to patients with MDD. The correlates of QoL differed between patients with schizophrenia and patients with MDD. This study adds to the understanding of QoL among patients with mental illnesses and may aid in better management of these patients with different psychiatric diagnoses.
临床医生和医护人员为精神障碍患者提供治疗的目标，已经从单纯关注症状转向关注功能改善。本研究旨在比较精神分裂症谱系障碍和重度抑郁症（MDD）患者的主观生活质量（QoL）。
使用 36 项短表健康调查工具收集 QoL 评分。使用协方差分析比较 203 例精神分裂症谱系障碍门诊患者和 185 例 MDD 门诊患者的 QoL 评分。采用阳性和阴性症状量表评估精神分裂症患者的精神症状严重程度，采用患者健康问卷-8 项评估 MDD 患者的抑郁症状严重程度。采用多元线性回归分析社会人口学因素和核心精神症状与 QoL 的相关系数（r）。
与 MDD 患者相比，精神分裂症患者除身体功能（PF）外，所有 QoL 子领域的健康评分均较高。在精神分裂症患者中，年龄较大与更好的心理健康（MH，r=0.35）和 PF（r=0.37）相关。与华人相比，马来人、印度人和其他族裔的 PF 评分较差（马来人 r=-0.43；印度人 r=-0.30；其他族裔 r=-0.34）。精神疾病持续时间较长与 MH 较差（r=-0.30）、PF 较差（r=-0.38）和身体健康问题导致的角色限制较差（r=-0.30）相关。在 MDD 患者中，年龄较大与 PF 较差（r=-0.33）相关，无共患躯体疾病的患者报告更少的躯体疼痛（r=0.45）和更好的一般健康（r=0.34）。此外，精神分裂症患者的所有精神症状均与 QoL 呈负相关，但与 MDD 患者的抑郁症状与 QoL 的相关性相比，其相关性较弱。
与 MDD 患者相比，精神分裂症患者总体报告的 QoL 较好。精神分裂症患者和 MDD 患者的 QoL 相关因素不同。本研究增加了对精神疾病患者 QoL 的了解，并可能有助于更好地管理不同精神诊断的患者。
