title: Depression and quality of life in first-episode psychosis.
abstract: OBJECTIVE
  Quality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL.
  
  
  METHODS
  We assessed 208 individuals with first-episode non-affective psychosis using measures of diagnosis (Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), symptoms (Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning), insight (Birchwood Scale), duration of untreated psychosis (Beiser Scale), and QOL World Health Organisation Quality of Life Instrument (WHOQOL-Bref). We used multiple regression to determine the contribution of depressive symptoms to QOL domains while controlling for socio-demographic and other clinical characteristics.
  
  
  RESULTS
  There were complete data for 146 individuals with FEP. Quality-of-life domains were consistently predicted by depressive symptoms including depressive mood and hopelessness rather than biological symptoms of depression with those experiencing more depressive symptoms reporting worse QOL. Those who were treated as in-patients reported improved QOL, and hospitalization was an independent predictor of most QOL domains. In-patients displayed greater levels of positive symptoms with those involuntarily detained displaying greater levels of bizarre behavior, thought disorder, and delusions.
  
  
  CONCLUSIONS
  These findings suggest that QOL is heavily influenced by depressive symptoms at initial presentation; however, as QOL domains are also influenced by admission status with in-patients being more symptomatic in terms of positive symptoms, subjective QOL assessment may be compromised during the acute phase of illness by both positive and depressive symptom severity.
authors.affiliation: DETECT Early Psychosis Service, Dublin, Ireland. laoise.renwick@detect.ie
authors.forename: Laoise
authors.initials: L
authors.lastname: Renwick
authors.forename: Deirdre
authors.initials: D
authors.lastname: Jackson
authors.forename: Sharon
authors.initials: S
authors.lastname: Foley
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Owens
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ramperti
authors.forename: Caragh
authors.initials: C
authors.lastname: Behan
authors.forename: Mansoor
authors.initials: M
authors.lastname: Anwar
authors.forename: Anthony
authors.initials: A
authors.lastname: Kinsella
authors.forename: Niall
authors.initials: N
authors.lastname: Turner
authors.forename: Mary
authors.initials: M
authors.lastname: Clarke
authors.forename: Eadbhard
authors.initials: E
authors.lastname: O'Callaghan
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology; D011788:Quality of Life; D012044:Regression Analysis; D012559:Schizophrenia / Q000453:epidemiology*; D012565:Schizophrenic Psychology