DMU Psychiatrie et Addictologie, Service de Psychiatrie et d'Addictologie de l'Adulte et du Sujet Âgé, Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Hôpital Corentin Celton, AP-HP.Centre, Université de Paris, Paris, France.
Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.
Soc Psychiatry Psychiatr Epidemiol. 2021 Aug;56(8):1411-1425. doi: 10.1007/s00127-020-01880-2. Epub 2020 May 15.
Numerous factors are known to influence quality of life of adults with schizophrenia. However, little is known regarding the potential predictors of quality of life in the increasing population of older adults with schizophrenia. The main objective of the present study was to propose a comprehensive model of quality of life in this specific population.
Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with schizophrenia or schizoaffective disorder recruited from French community mental-health teams. We used structural equation modeling to simultaneously examine the effects of six broad groups of clinical factors previously identified as potential predictors of quality of life in this population, including (1) severity of general psychopathology, (2) severity of depression, (3) severity of cognitive impairment, (4) psychotropic medications, (5) general medical conditions and (6) sociodemographic characteristics.
General psychopathology symptoms, and in particular negative and depressive symptoms, cognitive impairment, reduced overall functioning and low education were significantly and independently associated with diminished quality of life (all p < 0.05). Greater number of medical conditions and greater number of antipsychotics were also independently and negatively associated with quality of life, although these associations did not reach statistical significance in sensitivity analyses, possibly due to limited statistical power.
Several domains are implicated in quality of life among older adults with schizophrenia. Interventions targeting these factors may help improve importantly quality of life of this vulnerable population.
许多因素都会影响精神分裂症成年患者的生活质量。然而，对于日益增加的老年精神分裂症患者群体中生活质量的潜在预测因素，人们知之甚少。本研究的主要目的是提出一个适用于该特定人群的生活质量综合模型。
数据来自 55 岁及以上精神分裂症患者队列研究（CSA），这是一项从法国社区心理健康团队招募的大型（N=353）多中心老年精神分裂症或分裂情感障碍患者的研究。我们使用结构方程模型同时检验了先前确定的 6 个广泛的临床因素组对该人群生活质量的潜在预测作用，包括（1）一般精神病理学严重程度，（2）抑郁严重程度，（3）认知障碍严重程度，（4）精神药物，（5）一般医疗状况和（6）社会人口统计学特征。
一般精神病理学症状，特别是阴性和抑郁症状、认知障碍、整体功能下降和受教育程度低与生活质量下降显著相关（均 P<0.05）。更多的医疗状况和更多的抗精神病药物也与生活质量独立且负相关，尽管在敏感性分析中这些关联没有达到统计学意义，这可能是由于统计能力有限。
多个领域与老年精神分裂症患者的生活质量相关。针对这些因素的干预措施可能有助于显著改善这一弱势群体的生活质量。
