Dimensional symptom severity and global cognitive function predict subjective quality of life in patients with schizophrenia and healthy adults

Abstract

Over the last several decades Quality of Life (QoL) has become increasingly important as an indicator of treatment outcomes; particularly in schizophrenia spectrum disorders because of its close association with functional disability. Numerous studies seeking to elucidate the factors that contribute to QoL in this population have implicated both symptom severity and cognition in determining QoL but the findings have been mixed. The critical factors that appear to impede the lack of consensus in the extant literature examining determinants of QoL include the heterogeneity of the samples and measures examined as well as medication effects across different studies. Thus, the present study sought to address some of these issues by examining the relationship between subjective QoL and both symptom severity and cognitive function in a relatively homogeneous patient sample of patients and a community control sample assessed for dimensional symptom severity. Our results suggest that both global cognitive function and psychiatric symptoms have a significant impact on the subjective QoL of both people with schizophrenia spectrum disorders and psychiatrically healthy adults. Specifically, we found that a global index of cognition as well as self-reported avolitional and depressive symptoms were significantly predictive of QoL in both samples. These findings highlight the importance of addressing cognitive, depressive and avolitional symptoms in the treatment of patients with schizophrenia spectrum disorders and suggest that improvements in these domains may have a meaningful impact on their overall QoL.

Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia

“…Depression, is very common after the recovery of clinical insight, with a post-schizophrenic depression rate of 27% [11], which can be caused by multiple factors, such as antipsychotics or their side effects. DeRosse et al found that depressive symptoms were significantly predictive of QOL as well as cognition in patients with schizophrenia [12]. Even after controlling for negative symptoms in multiple regression analysis, depressive symptoms were also an important independent predictor of all QOL domains [13].…”

<p>The modern perspective for long-acting injectables antipsychotics in the patient-centered care of schizophrenia</p>

“…Schizophrenia is a chronic syndrome involving different clinical dimensions and causing significant functional impairment with negative impact on QoL of patients and caregivers 2–4. Current key guidelines for the treatment of schizophrenia focus on maximizing patient’s adaptive functioning and QoL in a recovery-oriented approach 7,8.…”

“…Positive symptoms (eg, hallucinations, delusions) occur together with negative symptoms (eg, alogia, blunted affect), along with disorganization of speech and behavior and impairment of cognitive and executive functions 1. All these symptoms cause impairment of personal, social, and occupational skills, with profound negative impact on the patient’s quality of life (QoL) 2–4. Primary goals in the management of schizophrenia include not only achieving short- and long-term clinical remission but also maintaining physical and mental functioning while improving QoL and promoting the patient’s recovery 5,6.…”

Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire

“…Psychotic symptoms are immediate 3 or long-term 4 predictors of QoL, as well as depression and motivational deficits. 5 Cognitive functioning has been conceptualized as a core deficit of schizophrenia and reported as a significant determinant of functioning 6 and subjective outcome. 5,7 Furthermore, clinical and neuropsychological models have been enriched with the introduction of high-level reflexive functions that are referenced in the framework of metacognition.…”

“…5 Cognitive functioning has been conceptualized as a core deficit of schizophrenia and reported as a significant determinant of functioning 6 and subjective outcome. 5,7 Furthermore, clinical and neuropsychological models have been enriched with the introduction of high-level reflexive functions that are referenced in the framework of metacognition. This term refers to a large set of constructs encompassing "cognition about one's own cognition or cognitive phenomena," 8 thinking about thinking, the ability to evaluate one's own cognitive functioning.…”