Abstract

BackgroundThe relationship between cognitive impairments and subjective quality of life (sQOL) in schizophrenia remains indeterminate, relative to studies of objective QOL (oQOL), despite much previous work. This study sought to better characterise the cognition-sQOL relationship in schizophrenia by 1) examining associations between factor analysis-derived cognitive domains and sQOL, 2) investigating if these domains predicted sQOL over other demographic and clinical variables, and 3) exploring if clinical, demographic and functional variables moderated the significant relationships.Methods47 schizophrenia/schizoaffective disorder patients (age: M=43.72, SD=11.35) and 48 healthy controls (age: M=39.82, SD=13.89) were assessed. QOL was measured using the Lehman’s QOL Interview. Composite scores were created to represent oQOL and sQOL, and factor analysis (principal axis factoring with varimax rotation) assessed for latent domains within 14 cognitive tasks. Symptomatology was assessed using the PANSS and MADRS. Pearson’s correlations and a stepwise linear regression were conducted to examine the associations between cognition and sQOL before the moderation analyses.ResultsThree cognitive domains were derived: visuospatial planning, verbal linguistic and inhibition switching. Only tasks comprising the verbal linguistic cognitive domain were significantly associated with, and predicted, sQOL (p<.05). Moderation analyses revealed that the direction of this relationship differed between patients and healthy controls (p<.05), and was moderated in patients only by positive symptom severity (p<.05).DiscussionThe relationship between cognition and sQOL in schizophrenia is determined by, and more associated with, meaning-based cognitions. It is affected by symptomatology, notably positive symptoms, which lead to worsening sQOL among those with more intact verbal linguistic processing.

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