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首发精神病的生活质量:一种聚类分析方法。

Quality of life in first episode psychosis: a cluster analytic approach.

作者信息

Liao Z, Allott K, Anderson J F I, Killackey E, Cotton S M

机构信息

Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.

Orygen, Parkville, Melbourne, VIC, 3052, Australia.

出版信息

Qual Life Res. 2022 Jun;31(6):1807-1817. doi: 10.1007/s11136-021-03014-w. Epub 2021 Oct 18.

Abstract

PURPOSE

Quality of life is increasingly recognised as an important outcome for young people with first episode psychosis (FEP). The first aim was to determine whether distinct homogenous subgroups of young people with FEP could be delineated based on profiles on quality of life domains (Physical Health, Psychological, Social relationships and Environmental). The second aim was to examine the discriminant validity of these subgroups with respect to demographic, functioning and clinical features of FEP.

METHOD

Quality of life, demographic characteristics, clinical characteristics, cognition and functioning were assessed in 145 people with FEP. Cluster analysis using Ward's methods and Squared Euclidean Distance with a k-means verification were employed to identify subgroups with homogenous quality of life profiles. The clusters were externally validated using multinomial logistic regressions.

RESULTS

Three distinct quality of life profiles were identified: one with good quality of life across all domains (30%), one with poor quality of life particularly in Psychological and Social relationships domains (28%), and one 'intermediate' group with comparatively low Psychological quality of life (42%). Depression, semantic verbal fluency, social inclusion and social/occupational functioning showed associations with group membership.

CONCLUSION

Our results suggest the potential of maintaining relatively good quality of life despite the experience of FEP. Future research on interventions to improve quality of life may consider the potential of addressing depression, social inclusion and social/occupational functioning.

摘要

目的

生活质量日益被视为首发精神病(FEP)青年的一项重要预后指标。首要目标是确定能否根据生活质量领域(身体健康、心理、社会关系和环境)的概况,划分出FEP青年的不同同质亚组。第二个目标是检验这些亚组在FEP的人口统计学、功能和临床特征方面的判别效度。

方法

对145名FEP患者进行了生活质量、人口统计学特征、临床特征、认知和功能评估。采用Ward法和平方欧氏距离的聚类分析以及k均值验证来识别具有同质生活质量概况的亚组。使用多项逻辑回归对这些聚类进行外部验证。

结果

确定了三种不同的生活质量概况:一种在所有领域生活质量都良好(30%),一种在心理和社会关系领域生活质量较差(28%),还有一个“中间”组,其心理生活质量相对较低(42%)。抑郁、语义言语流畅性、社会融入以及社会/职业功能与分组有关。

结论

我们的结果表明,尽管经历了FEP,但仍有可能维持相对良好的生活质量。未来关于改善生活质量干预措施的研究可能会考虑解决抑郁、社会融入以及社会/职业功能问题的潜力。

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