Erlend Strand Gardsjord1, Kristin Lie Romm2, Jan Ivar Røssberg2, Svein Friis2, Helene Eidsmo Barder3, Julie Evensen4, Ulrik Haahr5, Wenche Ten Velden Hegelstad6, Inge Joa7, Jan Olav Johannessen7, Johannes Langeveld6, Tor Ketil Larsen8, Stein Opjordsmoen9, Bjørn Rishovd Rund10, Erik Simonsen11, Per Vaglum12, Ingrid Melle13. 1. Institute of Clinical Medicine, KG Jebsen Centre for Psychosis Research, Norwegian Centre for Mental Disorders Research, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway. Electronic address: e.s.gardsjord@medisin.uio.no. 2. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway. 3. Women and Children's Division, Oslo University Hospital, 0407 Oslo, Norway. 4. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway; Adult Psychiatric Department Vinderen, Diakonhjemmet Hospital, 0319 Oslo, Norway. 5. Psychiatric Research Unit, Region Zealand, 4000 Roskilde, Denmark. 6. Psychiatric Division, Network of Clinical Psychosis Research, Stavanger University Hospital, 4068 Stavanger, Norway. 7. Psychiatric Division, Network of Clinical Psychosis Research, Stavanger University Hospital, 4068 Stavanger, Norway; Faculty of Social Sciences, University of Stavanger, 4036 Stavanger, Norway. 8. Psychiatric Division, Network of Clinical Psychosis Research, Stavanger University Hospital, 4068 Stavanger, Norway; Department of Clinical Medicine, Section Psychiatry, University of Bergen, 5021 Bergen, Norway. 9. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway. 10. Department of Psychology, University of Oslo, P.O. 1094 Blindern, 0317 Oslo, Norway; Vestre Viken Hospital Trust, 3004 Drammen, Norway. 11. Psychiatric Research Unit, Region Zealand, 4000 Roskilde, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark. 12. Department of Behavioural Sciences in Medicine, University of Oslo, 0318 Oslo, Norway. 13. Institute of Clinical Medicine, KG Jebsen Centre for Psychosis Research, Norwegian Centre for Mental Disorders Research, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway.
Abstract
BACKGROUND: Subjective quality of life (S-QoL) is an important outcome measure in first-episode psychosis, but its associations with clinical predictors may vary across the illness course. In this study we examine the association pattern, including both direct and indirect effects, between specific predefined clinical predictors (insight, depression, positive psychotic symptoms and global functioning) and S-QoL the first ten years after a first-episode psychosis. METHODS: Three hundred and one patients with a first-episode psychosis were included at first treatment, and reassessed at 3 months, 1 year, 2 years, 5 years and 10 years after inclusion. At 10-year follow-up 186 participated. S-QoL was assessed with Lehman's Quality of Life Interview. Applying a structural equation model, we investigated cross-sectional association patterns at all assessments between the predefined clinical predictors and S-QoL. RESULTS: At baseline, only depression was significantly associated with S-QoL. At all follow-up assessments, depression and functioning showed significant associations with S-QoL. Insight was not associated with S-QoL at any of the assessments. Better insight, less depressive symptoms and less positive psychotic symptoms were all associated with higher functioning at all assessments. Functioning seems to mediate a smaller indirect inverse association between positive psychotic symptoms and S-QoL. The association pattern was stable across all follow-up assessments. CONCLUSIONS: Together with depression, functioning seems to be important for S-QoL. Functioning seems to be a mediating factor between positive symptoms and S-QoL. A focus on functional outcome continues to be important.
BACKGROUND: Subjective quality of life (S-QoL) is an important outcome measure in first-episode psychosis, but its associations with clinical predictors may vary across the illness course. In this study we examine the association pattern, including both direct and indirect effects, between specific predefined clinical predictors (insight, depression, positive psychotic symptoms and global functioning) and S-QoL the first ten years after a first-episode psychosis. METHODS: Three hundred and one patients with a first-episode psychosis were included at first treatment, and reassessed at 3 months, 1 year, 2 years, 5 years and 10 years after inclusion. At 10-year follow-up 186 participated. S-QoL was assessed with Lehman's Quality of Life Interview. Applying a structural equation model, we investigated cross-sectional association patterns at all assessments between the predefined clinical predictors and S-QoL. RESULTS: At baseline, only depression was significantly associated with S-QoL. At all follow-up assessments, depression and functioning showed significant associations with S-QoL. Insight was not associated with S-QoL at any of the assessments. Better insight, less depressive symptoms and less positive psychotic symptoms were all associated with higher functioning at all assessments. Functioning seems to mediate a smaller indirect inverse association between positive psychotic symptoms and S-QoL. The association pattern was stable across all follow-up assessments. CONCLUSIONS: Together with depression, functioning seems to be important for S-QoL. Functioning seems to be a mediating factor between positive symptoms and S-QoL. A focus on functional outcome continues to be important.
Authors: Sandra Chi Yiu Wong; Wing Chung Chang; Christy Lai Ming Hui; Sherry Kit Wa Chan; Edwin Ho Ming Lee; Yi Nam Suen; Eric Yu Hai Chen Journal: Eur Arch Psychiatry Clin Neurosci Date: 2021-07-25 Impact factor: 5.270