Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland.
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Schizophr Res. 2022 Jun;244:10-17. doi: 10.1016/j.schres.2022.04.008. Epub 2022 May 7.
Psychotic disorders differ in their impact on psychosocial functioning. However, few studies have directly compared psychosocial functioning and its determinants between schizophrenia, schizoaffective disorder (SAD), bipolar disorder (BD), and major depressive disorder with psychotic features (psychotic MDD).
We compared rates of independent living, employment, marriage, and having children between these diagnostic groups in a large national sample of participants with psychotic disorders in Finland.
A cross-sectional substudy of participants (N = 9148) aged 18 to 65 years in the Finnish SUPER study, recruited nationwide from health- and social care settings and with advertisements. Psychosis diagnoses, age of onset, and hospitalizations were collected from healthcare registers. Participants were interviewed for psychosocial functioning. Associations of age of onset, hospitalizations, gender, and education with psychosocial functioning were analyzed using logistic regression models.
Of participants, 13.8% were employed or studying, 72.0% living independently and 32.5% had children. Overall, BD was associated with best, SAD and psychotic MDD with intermediate, and schizophrenia with worst level of psychosocial functioning. Greatest differences were found in independent living (OR 4.06 for BD vs. schizophrenia). In multivariate models, gender and number of hospitalizations predicted employment, marriage, and independent living in all diagnostic categories, and age of onset in some diagnostic categories.
Level of functioning and psychosocial outcomes differed markedly between psychotic disorders, particularly in independent living. Outcomes were worst for schizophrenia and best for BD. Across all psychotic disorders, female gender and lifetime number of hospitalizations had strong independent associations with marriage, employment, and independent living.
精神病性障碍在对心理社会功能的影响方面存在差异。然而，很少有研究直接比较精神分裂症、分裂情感障碍（SAD）、双相情感障碍（BD）和有精神病特征的重性抑郁障碍（精神病性 MDD）之间的心理社会功能及其决定因素。
我们在芬兰一项全国性的大型精神病性障碍参与者研究（SUPER 研究）中，比较了这些诊断组之间独立生活、就业、婚姻和生育的比率。
这是一项芬兰 SUPER 研究的横断面亚研究，参与者为年龄在 18 至 65 岁之间的全国范围内从医疗保健和社会保健机构以及广告中招募的参与者。从医疗保健记录中收集精神病诊断、发病年龄和住院情况。通过访谈评估参与者的心理社会功能。使用逻辑回归模型分析发病年龄、住院、性别和教育与心理社会功能的关联。
在参与者中，13.8%有工作或正在学习，72.0%独立生活，32.5%有子女。总的来说，BD 与最佳心理社会功能相关，SAD 和精神病性 MDD 与中等水平相关，精神分裂症与最差水平相关。最大的差异存在于独立生活方面（BD 与精神分裂症的比值比为 4.06）。在多变量模型中，性别和住院次数预测了所有诊断类别的就业、婚姻和独立生活，以及某些诊断类别的发病年龄。
精神病性障碍之间的功能水平和心理社会结局差异显著，尤其是在独立生活方面。精神分裂症的结局最差，BD 的结局最好。在所有精神病性障碍中，女性性别和终生住院次数与婚姻、就业和独立生活有很强的独立关联。
