Effects of depression and cognitive impairment on quality of life in older adults with schizophrenia spectrum disorder: Results from a multicenter study

Rachel Pascal De Raykeer,H Gres,T Seguret,F Blanadet,F Getten,Christine-Vanessa Cuervo-Lombard,M Cabot,H Rahiou,A Rollet,D Sechter,A Metton,I Maurs-Ferrer,M Meniai,S Mazmanian,M Taleb,B Beaufils,M Mahi,E Baup,G Aurifeuille,T Bichet,Frédéric Limosin,A Viala,M Creixell,M Comisu,O Blanc,C Guggiari,P Dreano,P Fonfrede,F Costi,D Pringuey,E Venet,E Diers,X Zendjidjian,S Dirami,S Haouzir,C Scemama-Ammar,H Hadaoui,B Rousselot,D Donneau,S Rubingher,Yvonne Blumenstock,E Leroy,M Bareil-Guérin,C Wagermez,O Brochart,P Louville,A Semmak,B Bucheron,Cédric Lemogne,J Pellerin,C Barrouillet,H Bardou,D Arbault,A Dammak,V Vanhoucke,M.N Vacheron,B Hubsch,A Grassin Delyle,Nicolas Hoertel,S Taisne,J Adès,Pierre Lavaud,E Duprat,A Deperthuis,Arthur Kaladjian,K Benyacoub,C Clad-Mor,P Loeffel,C Liling,J Gauillard,P Legrand,J Ben Ayed,J Blanc-Comiti,A Radtchenko,J Mauvieux,A Leydier,L Reinheimer,D Thefenne,A Heron,B Segalas,A Brochard,E Mechin,Carlos Blanco,J Gremion,Hugo Peyre,P Gasnier,N Mages,R Tourtauchaux,B Cordier,P Barrau,H Denizot,P.M Llorca,P Paris,Vincent Camus ,Stéphane Lucas ,Liova Yon ,Christophe Guérin-Langlois ,Olivier Maillet ,Stéphanie Papin ,Antoine Rauzy ,Cyril Hazif‐Thomas ,Marleen Renard ,Didier Boussiron ,Fabien Gierski ,Michel Walter ,J B Denis ,J L Vurpas ,Veronica Ades ,Véronique Charlot ,Philippe Nubukpo ,Olivier Guillin ,Hélène Verdoux ,C.-E Rengade ,Aude Manetti ,J C Samuelian ,Pilar Barreto Martín ,J L Terra ,J P Courcelles ,Christine Passerieux ,Frédéric Slama ,Stéphane Perron ,Marion Leboyer ,Emmanuel Haffen ,Oussama Kébir ,Gilles Amar ,M T Vitré ,J.-M Chabannes ,H Cuché ,Céline Combes ,Marjolaine Masson ,J F Karnycheff ,Fabien Rondepierre ,Franck Schürhoff ,Margaux René ,Dominique Januel ,Lila Mékaoui ,François Godart ,François Petitjean ,Christophe Portefaix ,Cécile Omnès ,Philippe Reynaud ,Sarah Barrière ,Donald A Robin ,David Da Rin ,M O Krebs ,María Luisa Limón Mirón ,Céline Béra-Potelle ,Julie Perlbarg ,Maryse Benoît ,J.-P Schuster ,Diane Lévy-Chavagnat ,Cécile Hanon ,Charles Alezrah ,Véronique Griner ,Vincent Lemaire ,J P Salvarelli ,Ariane Petit ,Isabelle Amado ,Noélle De Oliveira Freitas ,Catherine Martelli ,Christine Fernandez ,Gilles Vidon ,Nadine Bazin ,Caroline Dubertret ,Michel Lejoyeux ,Didier Duthoit ,Ghassen Saba ,A.-M Bouysse ,Eric Tran ,Pierre Vandel ,Anne-Sophie Seigneurie ,Raphaël Gourévitch ,Delphine Raucher‐Chéné ,G Mora ,Alain Mihoubi ,Christelle Rodrigues ,Oana Cella Andrei ,Gary Archambault ,Isabelle Jalenques ,Christine Lajugie ,Thomas Charpeaud

doi:10.1016/j.jad.2019.05.063

Abstract

BackgroundLittle is known about the respective effects of depression and cognitive impairment on quality of life among older adults with schizophrenia spectrum disorder. MethodsWe used data from the Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with schizophrenia or schizoaffective disorder (N = 353). Quality of life (QoL), depression and cognitive impairment were assessed using the Quality of Life Scale (QLS), the Center of Epidemiologic Studies Depression scale and the Mini-Mental State Examination, respectively. We used structural equation modeling to examine the shared and specific effects of depression and cognitive impairment on QoL, while adjusting for sociodemographic characteristics, general medical conditions, psychotropic medications and the duration of the disorder. ResultsDepression and cognitive impairment were positively associated (r = 0.24, p < 0.01) and both independently and negatively impacted on QoL (standardized β = −0.41 and β = −0.32, both p < 0.01) and on each QLS quality-of-life domains, except for depression on instrumental role and cognitive impairment on interpersonal relations in the sensitivity analyses excluding respondents with any missing data. Effects of depression and cognitive impairment on QoL were not due to specific depressive symptoms or specific cognitive domains, but rather mediated through two broad dimensions representing the shared effects across all depressive symptoms and all cognitive deficits, respectively. LimitationsBecause of the cross-sectional design of this study, measures of association do not imply causal associations. ConclusionsMechanisms underlying these two broad dimensions should be considered as important potential targets to improve quality of life of this vulnerable population.

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