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Determinants of objective and subjective quality of life in first-time-admission schizophrenic patients in Poland: a longitudinal study

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Abstract

Objectives

This study involved a naturalistic, prospective project assessing objective and subjective dimensions of quality of life (QoL) and the range of its putative determinants in first-episode schizophrenia.

Methods

Seventy-four patients, mean age 24.7 years, participated in the study. The patients were assessed 1 month following the first hospitalisation (Time 1), 12 months later (Time 2), and 4–6 years after Time 1 (Time 3). The Social Functioning Scale and World Health Organisation Quality of Life-BREF (WHOQOL-BREF) were applied to evaluate objective and subjective QoL, respectively. The Positive and Negative Syndrome Scale was used to examine psychopathological status, and the Global Assessment Scale was applied to evaluate social adjustment prior to hospitalisation.

Results

The objective and subjective QoL was relatively low at Time 1. Over time, the objective QoL improved in three domains, decreased in one domain, and remained stable in three domains. The subjective QoL did not change. The most important predictors of both dimensions of QoL were psychopathology and duration of untreated psychosis.

Conclusions

Because psychopathology seems to have the greatest impact on the QoL, there is a need to develop community psychosocial treatment to reduce these symptoms and to support patients in the early phase of the disease.

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Abbreviations

QoL:

Quality of life

SFS:

Social Functioning Scale

PANSS:

Positive and Negative Syndrome Scale

GAS:

Global Assessment Scale

DUP:

duration of untreated psychosis

References

  1. Katsching, H. (2006). Quality of life in mental disorders: Challenges for research and clinical practice. World Psychiatry, 5, 139–145.

    Google Scholar 

  2. Farkhoury, W. K. H., & Priebe S. (2002). Subjective quality of life: its association with other constructs. International Review of Psychiatry, 14, 219–224.

    Article  Google Scholar 

  3. Lauer, G. (1999). Concepts of quality of life in mental health care. In: Priebe, S., Oliver, J. P. J., & Kaiser, W. (Eds.), Quality of life and mental health care (pp. 19–34). Philadelphia, PA: Wrightson Biomedical.

    Google Scholar 

  4. Ruggeri, M., Warner, R., Bissofi, G., & Fontecedro, L. (2001). Subjective and objective dimensions of quality of life in psychiatric patients: A factor analytical approach. The South-Verona Outcome Project 4. British Journal of Psychiatry, 178, 268–275.

    Article  PubMed  CAS  Google Scholar 

  5. Addington, J., Young, J., & Addington, D. (2003). Social outcome in early psychosis. Psychological Medicine, 33, 1119–1124.

    Article  PubMed  CAS  Google Scholar 

  6. Browne, S., Clarke, M., Gervin, M., Waddington, J. L., Larkin, C., & O’Callaghan, E. (2000). Determinants of quality of life at first presentation with schizophrenia British Journal of Psychiatry, 176, 173–176.

    Article  PubMed  CAS  Google Scholar 

  7. Galletly, Ch., Clark, C. R., McFarlane, A. C., & Weber, D. (1997). Relationships between changes in symptoms rating, neuropsychological test performance and quality of life in schizophrenic patients treated with clozapine. Psychiatry Research, 72, 161–166.

    Article  PubMed  CAS  Google Scholar 

  8. Ho, B., Nopoulos, P., Flaum, M., Arndt, S., & Andreasen, N. (1998). Two-year outcome in first-episode schizophrenia: Predictive value of symptoms for quality of life. American Journal of Psychiatry, 155, 1196–1201.

    PubMed  CAS  Google Scholar 

  9. Hofer, A., Rettenbacher, M., Widschwendter, Ch., Kemmler, G., Hummer, M., & Fleischhacker, W. W. (2006). Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder. European Archives of Psychiatry and Clinical Neurosciences, 256, 246–255.

    Article  Google Scholar 

  10. Karow, A., Moritz, S., Lambert, M., Schoder, S., & Krausz, M. (2005). PANSS syndromes and quality of life in schizophrenia. Psychopathology, 38, 320–326.

    Article  PubMed  CAS  Google Scholar 

  11. Priebe, S., Roeder-Wanner, U. U., & Kaiser, W. (2000). Quality of life in first-admitted schizophrenia patients: A follow-up study. Psychological Medicine, 30, 225–230.

    Article  PubMed  CAS  Google Scholar 

  12. Clarke, M., Whitty, P., Browne, S., McTigue, O., Kamali, M., Gervin, M., Kinsella, A., Paddington, J. L., Larkin, C., & O’Callaghan, E. (2006). Untreated illness and outcome of psychosis. British Journal of Psychiatry, 189, 235–240.

    Article  PubMed  Google Scholar 

  13. Drake, R. J., Haley, C. J., Akhtar, S., & Lewis, S. W. (2000). Causes and consequences of duration of untreated psychosis in schizophrenia. British Journal of Psychiatry, 177, 511–515.

    Article  PubMed  CAS  Google Scholar 

  14. Bailer, J., Brauer, W., & Rey, E-R. (1996). Premorbid adjustment as predictor of outcome in schizophrenia: Results of a prospective study. Acta Psychiatrica Scandinavica, 93, 368–377.

    Article  PubMed  CAS  Google Scholar 

  15. Haim, R., Rabinowitz, J., & Bromet, E. (2006). The relationship of premorbid functioning to illness course in schizophrenia and psychotic mood disorders during two years following first hospitalization. Journal of Nervous and Mental Disease, 194, 791–795.

    Article  PubMed  Google Scholar 

  16. Malla, A. K., Norman, R. M., Manchada, R., & Townsend, L. (2002). Symptoms, cognition, treatment adherence and functional outcome in first-episode psychosis. Psychological Medicine, 32, 1109–1119.

    Article  PubMed  CAS  Google Scholar 

  17. Eack, S. M., Newhill, Ch. E., Anderson, C. M., & Rotondi, A. J. (2007). Quality of life for persons living with schizophrenia: More than just symptoms. Psychiatric Rehabilitation Journal, 30, 219–222.

    Article  PubMed  Google Scholar 

  18. Howard, L., Leese, M., & Thornicroft, G. (2000). Social network and functional status in patients with psychosis. Acta Psychiatrica Scandinavica, 102, 376–385.

    Article  PubMed  CAS  Google Scholar 

  19. Haddock, G., Lewis, S., Bental, S., Dunn, G., Drake, R., & Tarrier, N. (2006). Influence of age on outcome of psychological treatment in first–episode of schizophrenia. British Journal of Psychiatry, 188, 250–254.

    Article  PubMed  Google Scholar 

  20. Roder-Wanner, U-U., & Priebe, S. (1998). Objective and subjective quality of life of first–admitted women and men with schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 248, 250–258.

    Article  PubMed  CAS  Google Scholar 

  21. Thornicroft, G., Leese, M., Tansella, M., Howard, L., Toulmin, H., Herran, A., & Schene, A. (2002). Gender differences in living with schizophrenia. A cross-sectional European multi-site study. Schizophrenia Research, 57, 191–200.

    Article  PubMed  Google Scholar 

  22. Bechdolf, A., Klosterkotter, J., Hambrecht, M., Knost, B., Kuntermann, Ch., Schiller, S., & Pukrop, R. (2003). Determinants of subjective quality of life in post acute patients with schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 253, 228–235.

    Article  PubMed  Google Scholar 

  23. Hansson, L., & Bjorkman, T. (2007). Are factors associated with subjective quality of life in people with severe mental illness consistent over time?–A 6-year follow-up study. Quality of Life Research, 16, 9–16.

    Article  PubMed  Google Scholar 

  24. Norman, R. M. G., Malla, A. K., McLean, T., Voruganti, L. P. N., Cortes, L., McIntosh, E., Cheng, S., & Rickwood, A. (2000). The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale. Acta Psychiatrica Scandinavica, 102, 303–309.

    Article  PubMed  CAS  Google Scholar 

  25. Sim, K., Mahendran, R., Siris, S. G., Heckers, S., & Chong, S. A. (2004). Subjective quality of life in first episode schizophrenia spectrum disorders with comorbid depression. Psychiatry Research, 129, 141–147.

    Article  PubMed  Google Scholar 

  26. Caron, J., Lecomte, Y., Stip, E., & Renaud, S. (2005). Predictors of quality of life in schizophrenia. Community Mental Health Journal, 41, 399–417.

    Article  PubMed  Google Scholar 

  27. Malla, A. K., Norman, R. M. G., McLean, T. S., MacDonald, C., McIntosh, E., Dean-Lashley, F., Lynch, J., Scholten, D., & Ahmed, R. (2004). Determinants of quality of life in first-episode psychosis. Acta Psychiatrica Scandinavica, 109, 46–54.

    Article  PubMed  CAS  Google Scholar 

  28. Ritsner, M., Gibel, A., & Ratner, Y. (2006). Determinants of changes in perceived quality of life in the course of schizophrenia. Quality of Life Research, 15, 515–526.

    Article  PubMed  Google Scholar 

  29. Malla, A., & Payne, J. (2005). First-episode psychosis: Psychopathology, quality of life, and functional outcome. Schizophrenia Bulletin, 31, 650–671.

    Article  PubMed  Google Scholar 

  30. Gupta, S., Andreasen, N. C., Arndt, S., Flaum, M., Hubbard, W., & Ziebell, S. (1997). The Iowa longitudinal study of recent onset psychosis: One-year follow-up of first episode patients. Schizophrenia Research, 23, 1–13.

    Article  PubMed  CAS  Google Scholar 

  31. Gorna, K., Jaracz, K., Rybakowski, F. (2005). Objective and subjective quality of life in schizophrenic patients after a first hospitalization. Roczniki Akademii Medycznej w Białymstoku, 50, 225–227.

    PubMed  Google Scholar 

  32. Cechnicki, A. (2001). Quality of life of schizophrenic patients–the results of authors’ own research. Psychoterapia, 2, 5–17.

    Google Scholar 

  33. World Health Organization. (1992). Schedule for clinical assessment in psychiatry. WHO: Geneva.

    Google Scholar 

  34. Załuska, M. (1997). Skala Funkcjonowania Społecznego (SFS) Birchwooda jako narzędzie oceny funkcjonowania chorych na schizofrenię. Postępy Psychiatrii i Neurologii, 6, 237–251.

    Google Scholar 

  35. Birchwood, M., Smith, J., Cochrane, R., Wetton, S., & Copestake, S. (1990). The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry, 157, 853–859.

    PubMed  CAS  Google Scholar 

  36. Jaracz, K., Kalfoss, M., Górna, K., & Bączyk, G. (2006). Quality of life in Polish respondents: Psychometric properties of the Polish WHOQOL - Bref. Scandinavian Journal of Caring Sciences, 20, 251–260.

    Article  PubMed  Google Scholar 

  37. Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from WHOQOL Group. Quality of Life Research, 13, 299–310.

    Article  PubMed  CAS  Google Scholar 

  38. Kay, S. R. (1987). The Positive and Negative Symptom Scale (PANSS) of schizophrenia. Schizophrenia Bulletin, 13, 261–276.

    PubMed  CAS  Google Scholar 

  39. Lindenmayer, J. P., Bernstein-Hyman, R., & Grochowski, S. (1994). Five-factor model of schizophrenia. Journal of Nervous and Mental Disease, 182, 631–638.

    Article  PubMed  CAS  Google Scholar 

  40. Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J. (1976). The Global Assessment Scale. Archives of General Psychiatry, 33, 766–771.

    PubMed  CAS  Google Scholar 

  41. King B. M., & Minium E. W. (2003). Statistical reasoning in psychology and education. (4th ed.) New York: Wiley.

    Google Scholar 

  42. Molenberghs, G., Thijs, H., Jansen, I., Beunckens, C., Kenward, M.G., Mallinckrod, C., & Carroll, R. J. (2004). Analyzing incomplete longitudinal clinical trial data. Biostatistics, 5, 445–464.

    Article  PubMed  Google Scholar 

  43. SPSS 12.0: SPSS brief guide. (2004). Chicago Inc.

  44. Fitzgerald, P. B., de Castella, R. A., Filia, K., Collins, J., Brewer, K., Williams, C. L., Davey, P., & Kulkarni, J. (2003). A longitudinal study of patient- and observer-rated quality of life in schizophrenia. Psychiatry Research, 119, 55–62.

    Article  PubMed  Google Scholar 

  45. Malla, A. K., Norman, R. M. G., McLean, T. S., & McIntosh, E. (2001). Impact of phase-specific treatment of first episode of psychosis on Wisconsin Quality of Life Index (client version). Acta Psychiatrica Scandinavica, 103, 355–361.

    Article  PubMed  CAS  Google Scholar 

  46. McGorry, P. D., Ewards, J., Michalopoulos, C., Harrigan, S. M., & Jackson, H. J. (1996). EPPIC: An evolving system of early detection and optimal management. Schizophrenia Bulletin, 22, 305–326.

    PubMed  CAS  Google Scholar 

  47. Sim, K., Chan, Y. H., Chua, T. H., Mahendran, R., Chong, S. A., McGorry, P. (2006). Physical comorbidity, insight, quality of life and global functioning in first episode schizophrenia: A 24–month, longitudinal outcome study. Schizophrenia Research, 88, 82–89.

    Article  PubMed  Google Scholar 

  48. Salome, F., Petitjean, F., Germain, C., & Demant J. C. (2004). The subjective quality of life of patients with schizophrenia: Influence of psychopathology and patients’ expectations. A comparative study. Encephale, 30, 60–68.

    Article  PubMed  CAS  Google Scholar 

  49. Harris, M. G., Henry, L. P., Harrigan, S. M., Purcell, R., Schwartz, O. S., Farrelly, S. E., Prosser, A. L., Jackson, H. J., & McGorry, P. D. (2005). The relationship between duration of untreated psychosis and outcome: An eight-year prospective study. Schizophrenia Research, 79, 85–93.

    Article  PubMed  Google Scholar 

  50. Huppert, J. D., Weis, K. A., Lim, R., Pratt, S., & Smith, T. E. (2001). Quality of life in schizophrenia: Contributions of anxiety and depression. Schizophrenia Research, 51, 171–180.

    Article  PubMed  CAS  Google Scholar 

  51. Eklund, M., & Bäckström, M. (2005). A model of subjective quality of life for outpatients with schizophrenia and other psychoses. Quality of Life Research, 14, 1157–1168.

    Article  PubMed  Google Scholar 

  52. Mercier, C., & King, S. (1994). A latent variable causal model of the quality of life and community tenure of psychotic patients. Acta Psychiatr Scandivca, 89, 72–77.

    Article  CAS  Google Scholar 

  53. Rüesch, P., Graf, J., Meyer, P. C., Rössler, W., & Hell, D. (2004). Occupation, social support and quality of life in persons with schizophrenia or affective disorders. Social Psychiatry and Psychiatric Epidemiology, 39, 686–694.

    Article  PubMed  Google Scholar 

  54. Zissi, A., Barry, M. M., & Cochrane, R. (1998). A mediational model of quality of life for individuals with severe mental health problems. Psychological Medicine, 28, 1221–1230.

    Article  PubMed  CAS  Google Scholar 

  55. Awad, A. G., Voruganti, L. N. P., & Helsegrave, R. J. (1997). A conceptual model of quality of life in schizophrenia: Description and preliminary clinical validation. Quality Life Research, 6, 21–26.

    Article  CAS  Google Scholar 

  56. Ritsner, M., Ben-Avi. I., Ponizovsky, A., Timinsky, I., Bistrov, E., & Modai, I. (2003). Quality of life and coping with schizophrenia symptoms. Quality of Life Research, 12, 1–9.

    Article  PubMed  CAS  Google Scholar 

  57. Ritsner, M. (2003). Predicting changes in domain-specific quality of life of schizophrenia patients. Journal Nervous Mental Disease, 191, 287–294.

    Article  Google Scholar 

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Acknowledgements

This study was supported by the State Committee for Scientific Research in Poland (ref. 2 PO5D 089 28). The authors are grateful to Dr. Marzenna Zakrzewska of Adam Mickiewicz University for her assistance in the statistical analysis and to Professor Geoffrey Shaw of Poznan University of Medical Sciences for his language revision of the manuscript.

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Authors and Affiliations

  1. Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Smoluchowskiego 11, 60-179, Poznan, Poland

    Krystyna Górna & Krystyna Jaracz

  2. Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland

    Filip Rybakowski & Janusz Rybakowski

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  1. Krystyna Górna
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  2. Krystyna Jaracz
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  3. Filip Rybakowski
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  4. Janusz Rybakowski
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Correspondence to Krystyna Górna.

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Górna, K., Jaracz, K., Rybakowski, F. et al. Determinants of objective and subjective quality of life in first-time-admission schizophrenic patients in Poland: a longitudinal study. Qual Life Res 17, 237–247 (2008). https://doi.org/10.1007/s11136-007-9296-z

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  • DOI: https://doi.org/10.1007/s11136-007-9296-z

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