Subjective quality of life among first-episode psychosis patients in Chennai, India and Montreal, Canada.

Abstract

Differences in subjective quality of life among persons receiving early intervention for psychosis in varying geo-sociocultural contexts have rarely been examined. Our prospective longitudinal study compared the quality of life of persons with first-episode psychosis receiving two years of similar early intervention in Chennai, India and Montreal, Canada. We hypothesized that general life satisfaction would be higher in Chennai compared to Montreal, and that social relations (a specific quality of life component) would also be higher in Chennai and positively contribute to general life satisfaction. Participants completed the general satisfaction and social relations domains of the Wisconsin Quality of Life Index at baseline, months 12 and 24. Baseline weighted mean general satisfaction and social relations scores were in the low to moderate range. Generalized estimating equation analyses showed that general satisfaction scores increased with time [Wald χ2 (1)=125.28, p<0.001] and were higher in Chennai than in Montreal [Wald χ2 (1)=7.50, p=0.006]. Social relations scores showed the highest association with general satisfaction scores (B=0.52), followed by positive symptom remission (B=0.24) and gender (B=0.18) with Chennai males having the highest general satisfaction scores. Social relations weighted mean scores increased with time [Wald χ2 (1)=87.30, p<0.001] and were positively associated with years of education [Wald χ2 (1)=4.76, p=0.029] and early negative symptom remission [Wald χ2 (1)=7.38, p=0.007]. Our results suggest that subjective quality of life may improve following early intervention for psychosis across contexts. Our findings advance knowledge about the role of sociocultural (e.g., gender) and clinical factors in influencing subjective outcomes in psychosis, and point to social support networks and symptom remission as avenues to boost quality of life.