Abstract
Quality of life (QoL) is often used as an outcome assessment in programs treating patients with first-episode psychosis (FEP). The aim of this study was to examine the longitudinal trend of subjective QoL among patients with FEP and identify the potential influence of patients' social-demographic/lifestyle factors on the trend of QoL. Two hundred and eighty subjects participated in the study. Patient's demographics and subjective QoL were collected at baseline, 6 months and 1 year follow-up. Data were analyzed with a fixed-effect general linear regression model. Subjective QoL demonstrated significant trends of improvement in all four subdomains (physical health, psychological health, social relationships, and environment). Compared with unemployed participants, employed participants were significantly associated with better social relationships (p = 0.005) and environment (p = 0.029) after adjusting for age and gender. Moderation analysis demonstrated a significant improvement of physical health, social relationships, and environment for participants with a higher level of educational achievement, but not for participants with a lower level of educational achievement. Our results indicate that patients with FEP experienced significant improvement in subjective QoL over a 1 year period. Being employed was associated with overall better social relationships and environment among patients with FEP and higher educational achievement was associated with improvement of physical health, social relationship, and environment. Hence, educational achievement and employment could be considered for future optimization of early psychosis intervention programs.
Highlights
The World Health Organization (WHO) has defined Quality of life (QoL) as individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns [1]
Participants’ baseline demographics and clinical characteristics are shown in Table 1. 91.2% of the participants were patients diagnosed with schizophrenia and related psychosis and 8.2% were patients diagnosed with mood disorder with psychotic symptoms
Patients with first episode psychosis (FEP) demonstrated a significant improvement of psychotic symptoms, general functioning and subjective QoL during the 1 year follow-up period
Summary
The World Health Organization (WHO) has defined QoL as individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns [1]. Severe positive and negative symptoms were strongly related to poor QoL among outpatients with schizophrenia [13, 17], while QoL was reported to be correlated with both psychotic and negative symptoms to a minor extent [18]. These inconclusive findings were most probably due to the heterogeneity of study design, patient setting, methods of recruitment, premorbid adjustment, varying instruments that were used for assessment of QoL and different approaches of statistical analysis
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