Relative Contributions of Psychiatric Symptoms and Neuropsychological Functioning to Quality of Life in First-Episode Psychosis

Abstract

Objective: To report 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-report instrument assessing physical, psychological, social and environmental aspects of QOL. A comprehensive neuropsychological battery was 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 flexibility, verbal fluency, verbal ability and sustained attention explained up to 28% of the variance in the four domains of QOL. However, in the presence of psychiatric symptoms, neuropsychological variables were no longer significant predictors for physical and psychological QOL; depression, general psychopathology and negative symptoms together explained up to 43% of the variance in QOL, with neuropsychological variables remaining significant for social and environmental QOL. Conclusions: In young people with their first episode of psychosis, QOL is more strongly related to levels of psychopathology, particularly depression, than neuropsychological deficits. This finding replicates previous studies in chronic schizophrenia that have suggested QOL is more strongly related to levels of psychopathology than the presence of neuropsychological deficits.

Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients

“…An analysis of covariance (ANCOVA) was used to compare the suicidal and non-suicidal groups on SQOL ratings. Depressive symptoms that have been associated with SQOL and suicidal behavior in previous research [9,42,43] were included as a covariate in comparison analyses. To investigate possible risk factors, we used binary logistic regression (Wald) forward stepwise analysis for prediction of lifetime suicide attempts and present suicidal ideations.…”

Self-help interventions for psychosis: A meta-analysis

“…Negative symptoms are; however, closely related to the associated outcomes studied in the current review. For example, Wegener et al (2005) reported that 43% of the variance in quality of life measures among those with psychosis can be explained by levels of depression, general psychopathology and negative symptoms, while several longitudinal studies support the notion that negative symptoms are important determinants of quality of life in those with psychosis (Ho, Nopoulos, Flaum, Arndt, & Andreasen, 1998;Priebe, Roeder-Wanner, & Kaiser, 2000). We therefore reiterate our call for further research to develop and test the efficacy of self-help interventions targeting the negative symptoms of psychosis, as such interventions may be most likely to influence outcomes.…”

Quality of life and its predictors in people with schizophrenia

“…Some studies demonstrated that cognitive dysfunction had a greater influence on schizophrenia patients' QOL than positive symptoms (33)(34)(35). On the other hand, some reported that neuropsychological function had a little impact on their QOL in the presence of some clinical symptoms (32,36). The discrepancy among these studies might have been caused by differences of sample population, cognitive tests, and QOL scales (32)(33)(34)36).…”