Abstract
BackgroundSubjective quality of life (SQoL) is an important outcome domain in individuals with at-risk mental state (ARMS) for psychosis. In an effort to better understand and maximize SQoL in ARMS populations, an increasing number of research has been conducted to investigate factors determining SQoL. This study aimed to examine clinical, functional and cognitive correlates of SQoL in Chinese young people presenting with ARMS in Hong Kong.MethodsThis is a naturalistic prospective study examining the longitudinal course of ARMS and prediction of psychosis in Hong Kong. In total, 110 Chinese participants aged 15 to 40 years presenting with ARMS were recruited from a territory-wide specialized early intervention service for psychosis. ARMS status was verified using Comprehensive Assessment for At-Risk Mental State (CAARMS). Assessments encompassing symptom profiles (Positive and Negative Syndrome Scale, PANSS; Montgomery-Asberg Depression Rating Scale, MADRS; Brief Negative Symptom Scale, BNSS), functioning (Social and Occupational Functioning Rating Scale, SOFAS) and a brief battery of cognitive tests was conducted. A validated Chinese version of SF12 questionnaire was used to measure SQoL. The current analysis focused on data collected at baseline.ResultsOf 110 ARMS participants, 48.2% were male. The mean age and educational level of the sample was 20.9 years (S.D.=6.7) and 11.4 years (S.D.=2.6), respectively. Correlation analyses revealed that SF12 mental health score was correlated with MADRS total score, BNSS total score and SOFAS score, while SF12 physical health score was correlated with PANSS positive symptom score only (p<0.05). Multiple linear regression analysis showed that only MADRS total score was independently associated with SF12 mental health score (p<0.001). SQoL measures were not correlated with any cognitive functions.DiscussionOur results were consistent with the literature which indicates that psychological domain of SQoL is significantly related to depressive symptoms in ARMS individuals. Further analysis on the longitudinal data regarding our prospective ARMS cohort will clarify variables predictive of SQoL at follow-up.
Highlights
Studies have shown that the risk of developing schizophrenia is associated with an increased risk of most other psychiatric disorders[1] and that the familial transmission of risk extends across diagnostic categories.[2]
In twin studies, unaffected twins may not be completely free of symptomatology even when they do not fulfill diagnostic criteria for a psychiatric illness, but this has not been systematically tested in a twin design
We conducted a multimodal, cross-sectional combined clinical and register-based nation-wide twin study, by including twin pairs where one or both twins had a diagnosis in the schizophrenia spectrum
Summary
A territory-wide specialized early intervention (EI) service for psychosis (EASY) has been implemented in Hong Kong since 2001, providing 2-year phase-specific early assessment and clinical care to young people aged 15–25 years presenting with first-episode psychosis (FEP). Methods: This study adopted case versus historical-control design, comparing patients received 3-year EASY treatment (EI group) with those managed by standard psychiatric care (SC group) prior to implementation of EASY extension in terms of treatment delay and outcomes in symptom and functioning. Comparison analyses on DUP and service utilization were based on record review data of 320 patients. Regarding follow-up outcomes, EI patients displayed lower levels of negative (p=0.044) and depressive symptoms (p=0.055), higher scores in RFS immediate social network (p=0.027) and lower rates of service disengagement (p=0.048) than SC patients even when SGA use and DUP were adjusted as covariates in analysis of covariance for comparison. Discussion: Our results indicate that extended EASY service achieve favorable outcomes in adult FEP patients on shortening of treatment delay and improvement in negative symptoms and social functioning, and service disengagement reduction. Sang Yup Lee[1], Kyung Sue Hong[2], Yeon Ho Joo[3], Shinsuke Koike[4], Yu Sang Lee*,5, Jun Soo Kwon6 1Yonsei University; 2Sungkyunkwan University School of Medicine, Samsung Medical Center; 3University of Ulsan College of Medicine; 4The University of Tokyo; 5Yongin Mental Hospital; 6Seoul National University College of Medicine
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