title: Quality of life is predictive of relapse in schizophrenia.
abstract: BACKGROUND
  The objective of this study was to evaluate whether quality of life (QoL), as measured by the SF36 and the Quality of Life Interview (QoLI), is predictive of relapse for patients with schizophrenia.
  
  
  METHODS
  Using data from a multicenter cohort study conducted in France, Germany, and the United-Kingdom (EuroSC), we performed Cox proportional-hazards models to estimate the associations between QoL at baseline and the occurrence of relapse over a 24-month period, with adjustment for age; gender; positive, negative and general psychopathology PANSS factors; functioning (GAF); medication; side-effects; and compliance measures.
  
  
  RESULTS
  Our sample consisted of 1,024 patients; 540 (53%) had at least one period of relapse, and 484 (47%) had no relapse. QoL levels were the most important features predicting relapse. We found that a higher level of QoL predicts a lower rate of relapse at 24 months: HR = 0.82 (0.74; 0.91), p < 0.001 for the SF36-Physical Composite Score; and HR = 0.88 (0.81; 0.96), p = 0.002 for the SF36-Mental Composite Score. These results were not confirmed using the QoLI: HR = 0.91 (0.81; 1.01), p = 0.083. To a lesser extent, older age, better functioning, and a higher compliance score also predict a lower rate of relapse at 24 months (HRs from 0.97 to 0.98; p < 0.05).
  
  
  CONCLUSIONS
  QoL, as assessed by the SF36, is an independent predictor of relapse at a 24-month follow-up in schizophrenia. This finding may have implications for future use of the QoL in psychiatry. Moreover, our findings may support the development and monitoring of complementary therapeutic approaches, such as 'recovery-oriented' combined with traditional mental health cares to prevent relapse.
authors.affiliation: Aix-Marseille Univ, EA 3279 Research Unit, Marseille, 13284, France. laurent.boyer@ap-hm.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.forename: Aurelie
authors.initials: A
authors.lastname: Millier
authors.forename: Emeline
authors.initials: E
authors.lastname: Perthame
authors.forename: Samuel
authors.initials: S
authors.lastname: Aballea
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Mondher
authors.initials: M
authors.lastname: Toumi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D016016:Proportional Hazards Models; D011788:Quality of Life / Q000523:psychology*; D012008:Recurrence; D012559:Schizophrenia / Q000209:etiology*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires