title: Quality of life and functioning ability in subjects vulnerable to psychosis.
abstract: BACKGROUND
  It is well established that quality of life (QOL) and functioning ability are impaired in psychosis, especially schizophrenia. Little is known about QOL and functioning in subjects vulnerable to psychosis (VTP).
  
  
  METHODS
  Three samples of nonpsychotic subjects (first-degree relatives of psychotic or severely ill patients, treatment-seeking patients, and a random community sample, in all 133 subjects) were assessed by the Structured Interview for Prodromal Symptoms and their vulnerability to psychosis was defined by severity of lifetime psychotic-like positive symptoms (nonsymptomatic, symptomatic, VTP). Quality of life was assessed by the Heinrichs' Quality of Life Scale and the Global Assessment of Functioning Ability (GAF) was used to measure functioning. Variance of QOL and GAF was explained by vulnerability status and psychiatric symptoms.
  
  
  RESULTS
  Quality of life and functioning ability decreased linearly as positive symptom intensity increased and was lowest in the VTP subjects when background factors were controlled for. In multivariate analysis, negative symptoms predicted low QOL/GAF scores in addition to vulnerability status that was based on positive symptoms.
  
  
  CONCLUSIONS
  Vulnerability to psychosis is associated with decreased QOL and impaired functioning ability. Although current diagnostic evaluation of patients at high risk of psychosis relies heavily on the occurrence of positive symptoms, negative symptoms seem to be strongly associated with QOL and functioning ability in VTP subjects. This should be taken into account when assessing putatively vulnerable patients and planning treatment interventions for them.
authors.affiliation: Department of Psychiatry, University of Turku, 20700 Turku, Finland. tapasu@utu.fi
authors.forename: Tanja
authors.initials: T
authors.lastname: Svirskis
authors.forename: Jyrki
authors.initials: J
authors.lastname: Korkeila
authors.forename: Markus
authors.initials: M
authors.lastname: Heinimaa
authors.forename: Jukka
authors.initials: J
authors.lastname: Huttunen
authors.forename: Tuula
authors.initials: T
authors.lastname: Ilonen
authors.forename: Terja
authors.initials: T
authors.lastname: Ristkari
authors.forename: Jarmo
authors.initials: J
authors.lastname: Hietala
authors.forename: Erkka
authors.initials: E
authors.lastname: Syvälahti
authors.forename: Thomas
authors.initials: T
authors.lastname: McGlashan
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.forename: Raimo K R
authors.initials: RK
authors.lastname: Salokangas
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000235:genetics* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012919:Social Behavior