Subjective and objective quality of life in schizophrenia.
OBJECTIVE
Quality of life (QOL) is considered an important outcome in the treatment of schizophrenia, but the determinants of QOL are poorly understood in this population. Furthermore, previous studies have relied on combined measures of subjective QOL (usually defined as life satisfaction) and objective QOL (usually defined as participation in activities and relationships). We examined separately the clinical, functional, and cognitive predictors of subjective and objective QOL in outpatients with schizophrenia. We hypothesized that better subjective QOL would be associated with less severe negative and depressive symptoms, better objective QOL, and greater everyday functioning capacity, and that better objective QOL would be associated with less severe negative and depressive symptoms, better cognitive performance, and greater functional capacity.


METHODS
Participants included 88 outpatients with schizophrenia or schizoaffective disorder who completed a comprehensive series of assessments, including measures of positive, negative, and depressive symptoms; performance-based functional skills; a neuropsychological battery; and an interview measure of subjective and objective QOL.


RESULTS
In the context of multiple predictor variables, more severe depressive symptoms and better neuropsychological functioning were independent predictors of worse subjective QOL. More severe negative symptoms predicted worse objective QOL. Functional capacity variables were not associated with subjective or objective QOL.


CONCLUSIONS
Treatments to improve QOL in schizophrenia should focus on negative symptoms and depressive symptoms.
Narvaez
Jenille M
JM
University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive (0851), La Jolla, CA 92093, USA.
Twamley
Elizabeth W
EW
McKibbin
Christine L
CL
Heaton
Robert K
RK
Patterson
Thomas L
TL
D000203:Activities of Daily Living; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010549:Personal Satisfaction; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012944:Social Support