Disease Specific Variables Affecting Quality of Life in First-Episode Psychosis

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Measures of quality of life focus on assessment of health, comfort, and the happiness of an individual.
Measures of quality of life focus on assessment of health, comfort, and the happiness of an individual.

Quality of life decreases with the increased severity of symptoms in individuals with first-episode psychosis, according to a study published in Schizophrenia Research. A similar negative association was identified between quality of life and the length of time the psychosis had gone untreated.

This meta-analysis featured a review of 21 articles that included 3992 study participants. Negative correlations were found between quality of life and severity of symptoms (r=-0.32; P <.001) as well as between quality of life and the length of time of untreated psychosis (r=-0.21; P <.001). Heinrich's quality of life scale proved better able to accurately account for psychotic symptoms than similar quality of life measures. A noticeable effect was that general pathology and negative symptoms showed stronger associations with quality of life than did positive symptoms. The pooled results were adjusted for studies that were potentially missing from the dataset. 

Before exclusions, 51 studies were collected on PUBMED for this meta-analysis. All studies' publication dates were on or before August 29, 2016. The Q test and I2 statistics were used to assess study heterogeneity, which was addressed by conducting meta-regression analyses to investigate the potential role of moderators such as mean age, sex ratios, and sample size. To address publication bias, the funnel plot and "trim and fill" method were utilized.

The researchers conclude that, "[associations] were found between certain disease specific variables and quality of life in first episode psychosis, highlighting the relationship between symptom presentation and quality of life and the need for early intervention. Proper assessment of quality of life is important to promote improved quality of life in patients with first episode psychosis. Future research is needed to examine the interacting effects of symptom presentation, duration of untreated psychosis, and other variables, such as neurocognition, on quality of life."

Reference

Watson P, Zhang JP, Rizvi A, Tamaiev J, Birnbaum ML, Kane J. A meta-analysis of factors associated with quality of life in first episode psychosis [published online July 10, 2018]. Schizophrenia Research. doi: 10.1016/j.schres.2018.07.013 

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