Psychiatric Symptoms and Quality of Life in Schizophrenia: A Meta-Analysis

Abstract

Quality of life (QoL) has been recognized as an important outcome of schizophrenia treatment, yet the determinants of QoL for individuals with schizophrenia are not well known. Research has consistently found psychiatric symptoms to be negatively related to QoL, however, findings concerning the strength of these relationships have been mixed, making it difficult to determine the degree to which such symptoms are related to poor QoL. This research presents a systematic meta-analysis of studies examining the relationship between psychiatric symptoms and QoL in schizophrenia, in an effort to elucidate the determinants of QoL for this population. A total of 56 studies were extracted from literature searches of relevant databases for empirical reports published between 1966 and 2005 examining the relationship between positive, negative, and/or general psychiatric symptoms and QoL. Weighted effect size analyses revealed small relationships between psychiatric symptoms and QoL, with general psychopathology showing the strongest negative associations across all QoL indicators. Moderator analyses indicated that variation in effect sizes could be accounted for by differing operationalizations of QoL, study design, sample, and participant treatment setting. In particular, positive and negative symptoms were more strongly related to poor QoL among studies of schizophrenia outpatients, whereas general psychopathology showed a consistent negative relationship with QoL across all study samples and treatment settings. Implications for future research and treatment development are discussed.

The relationship between experiential deficits of negative symptoms and subjective quality of life in schizophrenia

“…The association between experiential deficits and SQOL appears to be significantly stronger than in previous studies which have examined the relationship to negative symptoms as a singular construct (Eack and Newhill, 2007;Narvaez et al, 2008;Priebe et al, 2011). In contrast to previous studies, the association between changes in experiential deficits and SQOL over time remained significant after controlling for depression (Priebe et al, 2011).…”

“…While there evidence of a strong association between negative symptoms and objective quality of life (OQOL) (Ho et al, 1998;Hunter and Barry, 2012;Milev et al, 2005;Whitty et al, 2008), only a weak association between negative symptoms and subjective quality of life (SQOL) has previously been found (Eack and Newhill, 2007;Fitzgerald et al, 2001;Narvaez et al, 2008;Priebe et al, 2011). This may be because SQOL is determined by multiple processes, including the comparison between expectations and aspirations, a comparison with others, and adaptation over time, all of which may result in a less negative appraisal by individuals with chronic schizophrenia (Priebe, 2007).…”

“…We tested the hypothesis that the association between negative symptoms and SQOL will relate exclusvely to experiential deficits, both cross sectionally and over time. We hypothesised that this relationship would remain after controlling for depressive symptoms, which is important given the association between low mood and SQOL (Eack and Newhill, 2007;Priebe et al, 2011). With evidence to suggest that the relationship between SQOL and symptoms may be different between men and women (Röder-Wanner and Priebe, 1998), and between those with a long and short illness duration (Priebe et al, 2000), a comparison between these groups was also considered.…”

The effect of service satisfaction and spiritual well-being on the quality of life of patients with schizophrenia

“…The impact of psychopathology on QOL has been controversial and a recent meta-analysis (Eack and Newhill, 2007) reported that QOL was only modestly related to symptoms of mental illness.…”

Applicability of the Spanish Version of the Supports Intensity Scale (SIS), in the Mexican Population with Severe Mental Illness

“…Extensive reviews show that psychiatric symptoms, in particular, and psychopathology in general are important, albeit modest, contributors to the quality of life of people with schizophrenia, and that the influence exercised by them depends in part on the sample of study (11) . The mentioned authors emphasize the need to examine other psychosocial influences.…”