Determinants of quality of life in first-episode psychosis (original) (raw)
Related papers
Subjective and objective quality of life at first presentation with psychosis
Early Intervention in Psychiatry, 2015
Aim: Quality of life (QOL) in firstepisode psychosis (FEP) is impaired when compared to non-clinical controls and several clinical factors including symptoms and untreated psychosis have been linked with poorer QOL. Measurement methods are varied, however, resulting in inconsistent findings and there is a need to simultaneously combine subjective and objective measures of QOL.
Schizophrenia Research, 2005
The concept of quality of life (QoL) is of growing relevance in schizophrenia research. However, there is to date no information on subjective QoL in subjects at risk for a first episode of psychosis in comparison to first episode schizophrenia patients (FE) or healthy controls (HC). Therefore 45 subjects in a putatively early initial prodromal state (EIPS), 40 FE and 45 HC were assessed on demographics, symptoms and subjective QoL as measured by the Modular System for Quality of Life. Results indicated that in most areas HC experienced the highest QoL scores followed in hierarchical order by EIPS and FE. EIPS and FE experienced significantly lower QoL than HC in 5 and 6 of 7 QoL domains. EIPS experienced the lowest ratings in affective QoL. Thus the data demonstrates that subjective QoL in subjects at risk for a first episode of psychosis is substantially reduced when compared with HC and suggests that subjective QoL is already compromised prior to the onset of first positive schizophrenia symptoms. These findings support the notion that subjects at risk for a first episode of psychosis constitute a clinical population for which further service and intervention research is indicated.
Impact of Untreated Psychosis on Quality of Life in Patients with First-episode Schizophrenia
Quality of Life Research, 2005
Despite increasing interest in the quality of life (QOL) of psychiatric patients in recent years, few studies have focused on the potential adverse effects of the illness on QOL during the period of untreated psychosis. Our study compares the QOL of patients with first-episode schizophrenia when they first presented to the psychiatric service with that of the normal population, and identifies possible relationships with various clinical parameters. One hundred and seventeen patients with schizophrenia (aged 14-28 years) who entered the Early Assessment Services for Young People with Psychosis (EASY) programme in Hong Kong
Aims: The understanding of factors related to poor subjective quality of life (sQoL) in early psychosis patients is important for both research and treatment efforts. This study examined how sQoL is associated with age at onset of prodromal symptoms, duration of untreated illness (DUI), symptom severity, premorbid functioning and current functional impairment in At-Risk Mental State (ARMS) for psychosis patients. Methods: 40 ARMS patients were assessed for sQoL, symptom severity, premorbid functioning, and social and role functioning. Results: As expected, a large number of significant and negative correlations between sQoL domains and several symptom dimensions emerged, especially for negative symptoms, behavioural change and depression. Poor premorbid functioning in late adolescence was associated with impairments in the psychological health and social relationships domains of sQoL. Current functional impairment was associated with all sQoL domains. Neither age at onset of prodromal symptoms nor DUI were related with sQoL. Conclusions: Findings indicate that different domains of sQoL are differentially and meaningfully associated with symptom severity and functional impairment, suggesting that greater symptom severity and poor functioning are already related with decreased sQoL in the ARMS for psychosis stage. Furthermore, findings highlight the importance of examining functional impairment and affective-motivational symptoms in future research on sQoL in ARMS populations due to their strong relationship with poor sQoL. Finally, findings underscore the importance of addressing the social and occupational dysfunctions already present in early psychosis with psychosocial interventions.
Health-related quality of life and psychiatric comorbidity in first episode psychosis
Comprehensive Psychiatry, 2005
Background: Quality of life (QOL) has been increasingly recognized as an important outcome measure in the care of patients with severe mental illnesses. This study seeks to evaluate the health-related QOL in patients with first episode psychosis and comparing those with psychiatric comorbidity to those without in an Early Psychosis Intervention Program. Methods: Overall, 131 patients with first episode psychosis were evaluated on their principal Axis I diagnosis and any other comorbid diagnosis, severity of psychopathology, insight, social/occupational functioning, and QOL, respectively. Results: Patients with psychiatric comorbidity scored lower on Positive and Negative Symptom Scale positive symptom subscale (z = À2.84, P b .01), had a greater awareness of their mental illness (z = À3.44, P b .001) and its social consequences (z = À3.24, P b 0.001), but lower ratings on the overall QOL (z = À3.06, P b 0.01) as well as in the individual domains (physical, psychological health, social relationships, environment, all P b .05) compared with patients without any psychiatric comorbidity. On multivariate analysis, being single and the presence of psychiatric comorbidity were associated with a poorer QOL in the various subdomains. Conclusions: The association of psychiatric comorbidity with poorer QOL warrants attention. The differences in the clinical correlates may provide potential targets for early identification and highlight needs that are significant to these patients with first episode psychosis and psychiatric comorbidity. D
Quality of life as an outcome of psychosis: implications for recovery
Schizophrenia …, 2011
Background: Quality of life (QoL) is an important outcome from a patient's perspective, but remains poorly understood in first episode psychosis (FEP) research. The overall aim of this paper is to describe methodological and conceptual issues associated with QoL as an ...
Australian & New Zealand Journal of Psychiatry, 2005
Objective: To repor t on the relationship between quality of life (QOL), psychiatric symptoms and neuropsychological functioning in a sample of young people who have experienced a first episode of psychosis 2–3 years following initial presentation. Method: Fifty-one participants aged 15–27 years old completed the short form of the World Health Organization Quality of Life scale (WHOQOL-Brèf), a self-repor t instrument assessing physical, psychological, social and environmental aspects of QOL. A comprehensive neuropsychological batterywas administered. Measures of psychiatric symptoms including depression (as assessed by the Calgary Depression Scale), positive, negative and general psychopathology (as assessed by the Positive and Negative Syndrome Scale) were obtained. Results: Multiple regression analyses were used to evaluate the ability of neuropsychological measures and psychiatric symptoms to predict QOL. When neuropsychological variables were considered on their own, cognitive ...
Psychological Medicine, 2008
BackgroundThe association between the duration of untreated psychosis (DUP) and outcome of schizophrenia may be confounded by other factors such as poor pre-morbid adjustment. The aim of the present study was to examine the independent contributions of DUP and of pre-morbid adjustment to the clinical and social outcomes of schizophrenia.MethodA longitudinal, prospective, 2-year follow-up study of 423 patients with first-episode schizophrenia-spectrum psychosis was conducted. Patients were comprehensively assessed at entry, 1-year and 2-year follow-up. At entry, DUP was measured by IRAOS (an instrument for the assessment of onset and early course of schizophrenia) and pre-morbid adjustment was measured by the Pre-morbid Adjustment Scale (PAS) as ‘pre-morbid social adaptation’ and ‘pre-morbid school adaptation’. Outcome measures included the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Social Network Schedule and s...