Predictors of Quality of Life in Major Psychoses: A Naturalistic Follow-Up Study
J Clin Psychiatry 2003;64(3):308-315
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Improved quality of life (QOL) of
patients suffering from major psychoses has become an important
treatment goal. We sought to determine predictors of perceived
QOL and to explore the changes that occur regarding QOL among
individuals with schizophrenia as compared to patients with
Method: In a naturalistic longitudinal design,
148 inpatients with schizophrenia and 51 inpatients with
schizoaffective/mood disorders (DSM-IV) were tracked for 16
months (SD = 4.6 months). Subjects were assessed at 2 timepoints
for psychopathology, stress process-related factors, and
perceived QOL, as measured by the Quality of Life Enjoyment and
Satisfaction Questionnaire. Predictors of fluctuations in QOL
index scores during the follow-up period were identified using
multiple regression techniques.
Results: We found that poor QOL is
not a more severe problem for schizophrenia patients than for
schizoaffective/mood disorder patients. Improved QOL of
schizophrenia patients is associated with reduced paranoid and
distress (obsessiveness, somatization) symptoms and increased
self-efficacy and self-esteem ratings. Individual changes in QOL
index scores among patients with schizoaffective/mood disorders
are associated with changes in depression, sensitivity, expressed
emotion, and task-oriented coping scores.
Conclusion: Predictors of changes in
satisfaction with life quality over time among schizophrenia
patients are distinct from those associated with
schizoaffective/mood disorders. Changes in stress process-related
factors, rather than psychopathology, predict change in perceived
QOL and should be considered when evaluating QOL outcomes.