Subjective QoL, psychosocial functioning independent in schizophrenia
MedWire News: Subjective quality of life (QoL) and psychosocial functioning are independent constructs in schizophrenia and should be assessed separately, results of a study suggest.
Indeed, the severity of illness symptoms seems to have a greater influence on social functioning than on subjective QoL.
"Although there is some overlap between QoL and functioning, often measured with the same instruments, these seem to be relatively independent concepts," Sofia Brissos (Psychiatric Hospital Centre, Lisbon, Portugal) and colleagues comment.
Psychosocial functioning and QoL are increasingly recognized as important treatment outcomes in schizophrenia, although there is no unanimous definition of either.
Objective measures of QoL include indicators of health and living conditions, sociodemographic items, and role functioning, whereas subjective QoL includes life satisfaction in general and within different life domains.
Social functioning includes the capacity of a person to function in different societal roles such as homemaker, worker, student, spouse, family member, or friend.
"In the present study, we intended to investigate the relationship between clinician-rated social functioning and self-reported QoL in a sample of 76 patients with schizophrenia living in the community," Brissos et al explain.
Social functioning was measured with the Personal and Social Performance (PSP) scale, and subjective QoL with the WHO Quality of Life Measure-Abbreviated Version (WHOQOL-Brief). Symptom severity and insight were assessed with the Positive and Negative Syndrome Scale (PANSS).
The majority of patients were single (78%), unemployed or inactive (74%), and only six (7.9%) had never been hospitalized.
The average PSP total score was 55.5 and mean scores on WHOQOL-Brief domains ranged from 54.1 to 63.0.
Greater symptom severity on all PANSS subscales and poor insight were significantly and strongly associated with worse functioning in all PSP domains.
By contrast, symptom severity was more moderately correlated with subjective QoL, with no significant correlations between QoL and positive symptoms or insight levels.
Furthermore, there were no significant associations between PSP domains and PSP total score and all WHOQOL domains controlling for symptom severity.
"A broader research approach, with increased attention to social and psychological factors, may help identify treatment targets to improve schizophrenia patients' social functioning and QoL," Brissos et al comment.
The results are published in the European Archives of Psychiatry and Clinical Neuroscience.
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By Andrew Czyzewski