Rotstein Anat, Shadmi Efrat, Roe David, Gelkopf Marc, Levine Stephen Z
Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
BJPsych Open. 2022 Feb 1;8(2):e35. doi: 10.1192/bjo.2022.3.
Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly.
To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia.
The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort.
A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93-0.99; adjusted HR = 0.96, 95% CI 0.93-0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93-1.02; adjusted HR = 0.97, 95% CI 0.93-1.02).
Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.
来自各种来源的证据表明，尽管精神分裂症女性患者的病程较轻，但她们报告的生活质量往往低于男性患者。然而，此前的研究尚未对此进行直接检验。
在一个全国性的精神分裂症样本中，研究生活质量与后续精神科住院风险之间关联的性别差异。
样本包括989名（60.90%）男性和635名（39.10%）女性，他们均符合ICD-10精神分裂症诊断标准。使用曼彻斯特生活质量简短评估量表对生活质量进行评估和评分。根据精神科住院次数评估精神分裂症的病程。参与者完成生活质量评估，随后进行18个月的随访，以记录后续的精神科住院情况。通过Cox比例风险回归模型估计未调整及调整协变量（精神分裂症发病年龄和出生年份）后的风险比（HR）。分别对男性、女性以及整个队列进行分析。
在随访期间，有93名男性和55名女性被送入精神科住院。较高的生活质量得分与男性后续住院风险降低显著相关（P < 0.05）（未调整：HR = 0.96，95% CI 0.93 - 0.99；调整后HR = 0.96，95% CI 0.93 - 0.99），但与女性无关（未调整：HR = 0.97，95% CI 0.93 - 1.02；调整后HR = 0.97，95% CI 0.93 - 1.02）。
精神分裂症患者的生活质量是一个具有性别特异性的概念，在临床实践和未来研究中应予以考虑。
