Lower Subjective Quality Of Life Research Articles

#1396 Anxiety level in kidney transplant recipients with adverse cardiovascular events

Abstract Background and Aims Kidney transplantation is the most cardioprotective method of renal replacement therapy and it has a positive effect on the psycho-emotional state of patients. However, kidney transplant recipients have a higher cardiovascular risk and a higher prevalence of anxiety and depression than people in the general population. The aim of the study was assessment of anxiety levels and the quality of life of kidney transplant recipients preceding adverse cardiovascular events. Method The study included 154 kidney transplant recipients. 54 (35.1%) of them had adverse cardiovascular events (acute coronary syndrome, complicated hypertensive crisis or rhythm disturbance) for three years of observation. The comparison group was 100 (64.9%) recipients without cardiovascular complications during the observation period. The study groups were comparable by age, gender, graft function and traditional cardiovascular risk factors. Results The average level of situational anxiety of kidney transplant recipients was 39 ± 7, the level of personal anxiety—43 ± 8. The structure was dominated by recipients with moderate personal anxiety—55.2% (n = 85) and moderate situational anxiety—66.9% (n = 103). However, the proportion of persons with high personal anxiety was quite high—40.9% (n = 63). The structure of anxiety levels had no significant differences depending on subsequent cardiovascular complications. Nevertheless, kidney transplantation recipients with adverse cardiovascular events had higher previous level of situational anxiety than recipients without cardiovascular events—41 ± 7 versus 38 ± 7, p < 0.05. During the study kidney transplant recipients were asked to rate their quality of life on a scale of 1 to 10. Recipients with subsequent adverse cardiovascular events had a lower subjective quality of life than recipients without cardiovascular complications—7 (6-8) versus 8 (7-8), p < 0.01. Conclusion Based on the study it was found that recipients with adverse cardiovascular events in the late postoperative period are characterized by a higher level of situational anxiety and a lower quality of life before these complications.

Влияние гормональной терапии на субъективное качество жизни у транссексуалов

Background. There is an increase in demand for transgender transition, which is connected with social causes, as well as the possibilities of modern medicine. One of the stages includes hormone replacement therapy (HRT). There is no clear opinion on the effect of HRT on subjective well-being of transsexuals. A controversial point is the ambiguous effect of HRT. Objective. To compare the effect of HRT on the subjective quality of life of transgender and compare the results with other stages of transgender transition, as well as with a control group with cisgender people. Methods. The anonymous questionnaire includes the life satisfaction scale (Osin, Leontiev, 2008), and the Kuhn test “Who am I?” modified by A. Tkhostov, E. Rasskazova, V. Emelin (2014). ANOVA is used in the SPSS 23 program. Sample. Control group included 120 cisgender people. Research group consisted of 151 transsexuals. The main group is divided by gender (MtF — Male-to-Female; FtM — Female-to-Male) and the stage of transgender transition. Results. All transsexuals at the HRT stage demonstrate a low significance of self-identification in the “Who am I?” test (P < 0.001), which is not observed at other stages of gender correction. HRT has diametrically different effects on MtF and FtM. MtFs demonstrate low subjective quality of life (P < 0.001) and low social recognition scores (P < 0.001), while FtM — on the contrary. Conclusion. The stage of hormone replacement therapy in transsexuals is associated with a revision of identity, in which old self-identities lose relevance, and new ones have not yet been found. Perhaps the uncertain and crisis nature of such a psychological situation is the reason for the ambiguous effect of hormone therapy on the subjective quality of life of transsexuals in many scientific publications.

Sexual Minority Identities in Autistic Adults: Diversity and Associations with Mental Health Symptoms and Subjective Quality of Life.

Although disparities in mental health and subjective quality of life (QoL) have been reported for autistic adults, reasons for these disparities are poorly understood. A potential factor in these disparities is exposure to social stressors related to minority status (i.e., minority stress), including stigma and discrimination. Autistic individuals are more likely than nonautistic individuals to be from groups with other minority identities, including sexual minorities (i.e., sexual orientations such as asexual, bisexual, gay). However, to date, few studies have examined whether sexual minority autistic adults experience diminished mental health relative to heterosexual autistic adults, and no research has examined subjective QoL for sexual minority compared with heterosexual autistic adults. Participants were 651 autistic adults aged 18.5 to 83.3 years recruited through Simons Powering Autism Research's Research Match. All participants resided in the United States. Participants completed surveys online, including measures of anxious and depressive symptomatology, perceived stress, and subjective QoL. Participants reported their sexual orientation and other sociodemographic variables. A large proportion of autistic adults reported a sexual minority identity (41.2%), and a diversity of sexual identities was reported. Sexual minority autistic adults reported poorer mental health and lower subjective QoL across all assessed domains relative to heterosexual autistic adults. Understanding factors that may be associated with poorer mental health and decreased subjective QoL in autistic adults is critical and has been identified as a research priority by autistic stakeholders. The findings reported here underscore the need to examine mental health and subjective QoL disparities among autistic individuals within a societal context, taking into consideration the potential of intersecting minority identities and increased social stressors, as these added stressors may increase risks for poorer outcomes.

Co-occurring ADHD symptoms in autistic adults are associated with less independence in daily living activities and lower subjective quality of life.

Outcomes for autistic adults are generally poor, including activities of daily living and self-ratings of quality of life. Co-occurring psychiatric conditions contribute to these poor outcomes. Attention-deficit/hyperactivity disorder is one of the most common co-occurring conditions in autistic individuals. However, we know little about the association between attention-deficit/hyperactivity disorder symptoms and outcomes in autistic adults. A total of 724 autistic adults (18-83 years; 58% female) recruited from the Simons Foundation Powering Autism Research participant registry completed questionnaires on demographics, co-occurring psychiatric conditions, activities of daily living, and subjective quality of life. Autistic adults who rated themselves as having more attention-deficit/hyperactivity disorder symptoms also rated themselves as having less independence in activities of daily living and a lower quality of life. This is the first study to show these relationships in autistic adults. These findings highlight that additional research and better supports for co-occurring attention-deficit/hyperactivity disorder symptoms may be critical to improving independence and quality of life for autistic adults.

Clinical- and cost-effectiveness of a technology-supported and solution-focused intervention (DIALOG+) in treatment of patients with chronic depression\u2014study protocol for a multi-site, cluster randomised controlled trial [TACK

BackgroundMany with an acute depressive disorder go on to develop chronic depression, despite ongoing care. There are few specifically designed interventions to treat chronic depression. DIALOG+, a technology-assisted intervention based on the principles of solution-focused therapy, may be beneficial. It has been shown to be effective as a treatment for patients with psychotic disorders, especially in regards to increasing quality of life. DIALOG+ was designed to be flexibly applied and not diagnosis-specific, aiming to structure communication and generate a personally-tailored care plan. This cluster randomised controlled trial (RCT) is part of a programme of research to adapt and test DIALOG+ for patients with chronic depression.MethodsPatients will be eligible for the trial, if they have exhibited symptoms of depression or non-psychotic low mood for at least 2 years, have regular contact with a clinician and have a low subjective quality of life and moderate depressive symptoms. Clinicians, who routinely see eligible patients, will be recruited from a number of sites across NHS England. Clusters will have between 1 and 6 patients per clinician and will be randomised in a 1:1 ratio to either the intervention (DIALOG+) or active control group (treatment as usual + DIALOG scale). Clinicians in the intervention group are trained and asked to deliver the intervention regularly for 12 months. Active control participants receive treatment as usual and are asked to rate their satisfaction with areas of life and treatment on the DIALOG scale at the end of the clinical session. Approximately 112 clinician clusters will be recruited to reach a total patient sample size of 376. Clinical and social outcomes including costs are assessed at baseline and 3, 6 and 12 months post randomisation. The primary outcome will be subjective quality of life at 12 months.DiscussionThis definitive multi-site, cluster RCT aims to evaluate the clinical- and cost-effectiveness of DIALOG+ for people with chronic depression. If shown to be effective for this patient population it could be used to improve outcomes of mental health care on a larger scale, ensuring that patients with complex and co-morbid diagnoses can benefit.Trial registrationISRCTN11301686. Registered on 13 Jun 2019.

Understanding subjective quality of life in homeless and vulnerably housed individuals: The role of housing, health, substance use, and social support

PurposeMuch of the extant research on quality-of-life (QoL) in homelessness has focused narrowly on health-related QoL. Far less is known about broader subjective quality-of-life (SQoL). The purpose of this study was to examine levels and predictors of SQoL among homeless and vulnerably housed individuals in a 4-year longitudinal study. MethodsData were from the Health and Housing in Transition (HHiT) study, a prospective cohort study of 1190 individuals from three Canadian cities who were homeless or vulnerably housed. SQoL was measured using a scale designed specifically for this population. Predictor variables were time-varying indicators of housing status, substance use, and social support as well as baseline measures of physical and mental health problems. Generalized estimating equation (GEE) analysis examined these predictors of SQoL, adjusting for baseline age, gender, ethnicity, employment, income, and city of residence. ResultsParticipants at baseline were 18 to 80 years old (M = 42.2; SD = 10.6), 66% male, 63% White, 60% unemployed, and 50% were currently homeless. Most areas of SQoL tended toward slight satisfaction, with dissatisfaction concerning finance and employment as notable exceptions. Demographic variables were not associated with SQoL. Homelessness and self-reported presence of 3+ chronic health conditions, mental health problems, and problematic substance use, as well as lower perceived social support, were independently associated with lower SQoL. ConclusionsSQoL shows variation across different life areas for homeless and vulnerably housed individuals. In order to improve SQoL in this population, it is important to address poverty, employment, housing challenges, mental and physical health problems, and substance use as well as increase social supports.

Quality of life for older autistic people: The impact of mental health difficulties

BackgroundHaving a mental health condition is related to significantly lower subjective Quality of Life (QoL) for people on the autism spectrum. Many autistic people do not participate in so-called ‘normative’ outcomes, i.e. the achievement of lifecourse goals judged to be important by adults in the general population (e.g. being employed). This study aimed to investigate whether there is an association between the presence of mental health conditions, subjective QoL and participation in normative outcomes in older autistic people. Methods69 autistic people (n = 48 males) aged 55 years and over were identified from two studies that are part of the UK Autism Spectrum Adulthood and Ageing research programme. Participants provided demographic data to establish normative outcome participation, and completed the World Health Organisation (WHO) QoL measure (WHOQoL-BREF) and the Hospital Anxiety and Depression Scale (HADS). Illustrative quotes focusing on normative outcomes were available from in-depth interviews (n = 8). ResultsQoL scores across all domains were lower for individuals who met indicative clinical cut-offs for depression (F(8,126) = 6.171, p < 0.001); findings were similar for anxiety (F(8,126) = 3.902, p < 0.001). Subjective QoL did not differ according to participation in normative outcomes (F(12,124.64) = 1.363, p = 0.192). The illustrative quotes suggested that aspects of daily life were related to QoL (i.e. friendships). ConclusionsFor older autistic people, the presence and severity of a likely mental health condition (i.e anxiety and depression) were associated with poorer QoL. However, participation in general population lifecourse goals may not well represent QoL of older autistic people, suggesting that service supports should be individually responsive.

Субъективное качество жизни и психологическая адаптация у лиц с низким, средним и высоким уровнем эскапизма

The article presents the results of a study of Subjective quality of life and Psychological adaptation level among individuals with low, normal and high level of Escapism (N=329, 18-52 years old Russians from big cities). Four tests were applied including the new Escapism Scale. Individual with high level of Escapism have lower Subjective quality of life in several parameters — Stability in Country, Confidence in Future, Ecology, Social recognition, Interesting Job, Health and Active life, Internal Harmony and Inner Conflict absence, Privacy (as a Personal Space), Self-Confidence, (Subjective well-being Questionnaire, T. Savchenko, G. Golovina). ‘Excessive’ escapists also demonstrate lower level of psychological adaptation including Self-acceptance, Loyalty, Internality, Emotional Comfort, Intention to dominate (SPA Questionnaire, C. Rogers, R. Diamond). Because of that, Escapism can be characterized mainly as a compensational mechanism which emerges due to the reduced level of an individual’s adaptation to his/her social environment. The consistence of theoretical layout and empirical data obtained confirm the validity of presented Escapism Scale and its applicability for further empirical research.

Preferences for befriending schemes: a survey of patients with severe mental illness

BackgroundBefriending has become a widely used method for tackling social isolation in individuals with severe mental illness (SMI), and evidence exists to support its effectiveness. However, patient preferences for befriending remain unclear. We aimed to determine whether patients with SMI want a volunteer befriender and, if so, the volunteer characteristics and character of the relationship they would prefer.MethodsA survey of outpatients was conducted across London-based community mental health teams, for individuals diagnosed with affective or psychotic disorders. Questions consisted of measures of demographic characteristics, befriending preferences and social context, including measures of time spent in activities, number of social contacts, loneliness and subjective quality of life (SQOL). Binary logistic regressions were used to investigate potential predictors of willingness to participate in befriending.ResultsThe sample comprised of 201 participants with a mean age of 43 years. The majority (58%) of the sample indicated willingness to participate in befriending. In univariable analyses this was associated with less time spent in activities in the previous week, higher level of loneliness and lower SQOL. When all three variables were tested as predictors in a multivariable analysis, only lower SQOL remained significantly associated with willingness to take part in befriending.Relative to other options presented, large proportions of participants indicated preference for weekly (44%), 1-hour (39%) meetings with a befriender, with no limits on the relationship duration (53%). Otherwise, patient preferences exhibited great variability in relation to other characteristics of befriending schemes.ConclusionsA substantial number of patients with SMI appear willing to take part in a befriending scheme. Patients with lower SQOL are more likely to accept befriending, so that befriending schemes may be a realistic option to help patients with particularly low SQOL. The large variability in preferences for different types of befriending suggests that there is no one-size-fits-all formula and that schemes may have to be flexible and accommodate different individual preferences.

Anabolic steroid use among gay and bisexual men living in Australia and New Zealand: Associations with demographics, body dissatisfaction, eating disorder psychopathology, and quality of life

Background and aimsGay and bisexual men may be at heightened risk for using anabolic androgenic steroids (AAS). Few studies, however, have examined AAS use among gay and bisexual men living in countries outside the United States. In addition, few studies have explored the potential associations of AAS use with body image concerns beyond muscularity, including height and genitals, or with eating disorder symptoms and quality of life. Thus, we examined the associations of AAS use, and of thoughts about using AAS, with body image, eating disorder symptoms, and quality of life among gay and bisexual men living in Australia and New Zealand. MethodsA sample of 2733 gay and bisexual men completed an online survey promoted by paid nationwide advertisements to users of geosocial-networking smartphone applications. ResultsThe prevalence of AAS use, and of thoughts about using AAS, were 5.2% (95% confidence interval [CI]: 4.4%, 6.1%) and 25.4% (95% CI: 23.8%, 27.1%), respectively. Multivariate analyses revealed that more frequent thoughts about using AAS were associated with being older, taller, and experiencing greater dissatisfaction with muscularity and height, less dissatisfaction with body fat, greater eating disorder symptoms, and lower subjective quality of life. Actual AAS users were more likely to be older, from a non-Australian/New Zealander cultural background, experiencing less dissatisfaction with body fat, and experiencing greater eating disorder symptoms. ConclusionsPsychopathology related to body image and eating disorders are associated with AAS use among gay and bisexual men living in Australia and New Zealand.

Does functional motor incomplete (AIS D) spinal cord injury confer unanticipated challenges?

Examine psychological challenges associated with Spinal Cord Injury (SCI) among a cohort of Veterans. Research Method/Design: Cross-sectional descriptive study. SCI Centers participating in a multisite evaluation of longitudinal employment, quality of life, and economic outcomes among a large cohort of veterans with SCI, the Predictive Outcome Model Over Time for Employment (PrOMOTE) project. A total of 1,047 patients from participating SCI Centers provided baseline interviews. Main outcome measures included the Veterans RAND 36-Item Health Survey (VR-36) Mental Component Score (MCS); VR-36 Mental Health Scale; VR-36 Vitality Scale; VR-36 Bodily Pain Scale; Quick Inventory for Depressive Symptomatology, Self-Report (QIDS-SR); Patient Health Questionnaire-Depression Scale (PHQ-9); and Diener Satisfaction with Life Scale (SWLS). ANOVA analysis showed that persons with AIS D SCI evidenced higher self-reported depressive symptoms, higher pain, and a lower subjective quality of life. Individuals with functional motor incomplete spinal cord injury are more vulnerable to psychological distress and a low subjective quality of life than might be expected based on functional outcomes. Further study appears warranted to ascertain potential explanations for these findings. (PsycINFO Database Record

Insight, self-stigma and psychosocial outcomes in Schizophrenia: a structural equation modelling approach.

Poor insight is prevalent in patients with schizophrenia and has been associated with acute illness severity, medication non-adherence and poor treatment outcomes. Paradoxically, high insight has been associated with various undesirable outcomes, including low self-esteem, depression and low subjective quality of life (QoL) in patients with schizophrenia. Despite the growing body of studies conducted in Western countries supporting the pernicious effects of improved insight in psychosis, which bases on the level of self-stigma, the effects are unclear in non-Western societies. The current study examined the role of self-stigma in the relationship between insight and psychosocial outcomes in a Chinese population. A total of 170 outpatients with schizophrenia spectrum disorders were recruited from two general university hospitals. Sociodemographic data and clinical variables were recorded and self-report scales were employed to measure self-stigma, depression, insight, self-esteem and subjective QoL. Structural equation modelling (SEM) was used to analyse the cross-sectional data. High levels of self-stigma were reported by 39% of the participants (n = 67). The influences of insight, self-stigma, self-esteem and depression on subjective QoL were confirmed by the SEM results. Our model with the closest fit to the data (χ 2 = 33.28; df = 20; p = 0.03; χ 2/df = 1.66; CFI = 0.98; TLI = 0.97; RMSEA = 0.06) demonstrated that self-stigma might fully mediate the association of insight with low self-esteem, depression and poor subjective QoL. High insight into illness contributed to self-stigma, which caused low self-esteem and depression and, consequently, low QoL. Notably, insight did not directly affect self-esteem, depression or QoL. Furthermore, the association of insight with poor psychosocial outcomes was not moderated by self-stigma. Our findings support the mediating model of insight relevant to the poor psychosocial outcomes of individuals diagnosed with schizophrenia in non-Western societies, in which self-stigma plays a pivotal role. These findings elucidate the direct and indirect effects of insight on psychosocial outcomes and imply that identifying and correcting self-stigma in people with schizophrenia could be beneficial. Additional studies are required to identify whether several other neurocognitive or psychosocial variables mediate or moderate the association of insight with self-esteem, depression and QoL in patients with schizophrenia. Studies with detailed longitudinal assessments are necessary to confirm our findings.

Self-regulation and quality of life in high-functioning young adults with autism.

Background: Autism is generally associated with poor functional outcome but little is known about predictors of quality of life, especially during early adulthood. This study was conducted to assess subjective quality of life during early adulthood in high-functioning autism spectrum disorder and its relation with self-regulating abilities. Individuals with high-functioning autism spectrum disorder who progressed into post-secondary higher education (N = 75) were compared to a typical peer control group (N = 28) based on behavioral self-report questionnaires. The results indicated that individuals with high-functioning autism spectrum disorder reported significantly lower subjective quality of life than typical controls (p < 0.001, effect size (d) = 1.84). In addition, individuals with high-functioning autism spectrum disorder reported more problems with emotion processing (p < 0.05, effect size (d) = 0.79) and daily executive functioning (p < 0.001, effect size (d) = 1.29) than controls. A higher level of executive functioning problems was related to lower quality of life in the high-functioning autism spectrum disorder group, but no significant relation between level of emotion processing and subjective quality of life became apparent in the regression analysis. Our findings show that even in high-functioning young adults with autism, executive functioning, emotion processing, and subjective quality of life are low compared to typically developing peers. Furthermore, these results emphasize the importance of targeting executive functioning problems in individuals with autism to improve subjective quality of life.

Even mild depression is associated with among-day blood pressure variability, including masked non-dipping assessed by 7-d/24-h ambulatory blood pressure monitoring

The effect of mild depression on blood pressure (BP) was assessed in 116 Japanese (32–79 years). As compared to non-depressive (Geriatric Depression Scale, GDS-15 score <5) subjects, mild depressives (GDS-15 score: 1–15) had shorter sleep duration (p = 0.021), lower subjective quality of life (health: p = 0.016; life satisfaction: p < 0.001; and happiness: p < 0.001), and higher 7-d systolic BP (p < 0.05). “Masked non-dipping” (dipping on day 1, but non-dipping on at least 1 of the following 6 d) was more frequent among depressive than non-depressive normotensives (p = 0.008). Among-day BP variability may underlie cardiovascular disease accompanying a key component of psychological depression.

Associations between social participation and subjective quality of life for adults with moderate to severe traumatic brain injury

Purpose: To examine the association between social participation and subjective quality of life (SQOL) for non-employed, community-dwelling adults with moderate to severe traumatic brain injury (TBI) at 1 year or greater post-injury. Method: A correlational study was conducted involving 46 participants. Social participation was measured using the Community Integration Questionnaire, Social Provisions Scale and the Adult Subjective Assessment of Participation. SQOL was measured using the Quality of Life and Health Questionnaire, Abdel-Khalek Happiness Scale and UCLA Loneliness Scale. Results: Higher levels of happiness and global quality of life were each associated with higher levels of enjoyment, satisfaction with performance and higher proportion of activities performed with others. Lower levels of loneliness were associated with higher levels of general social integration and higher levels of perceived social supports. There were no associations found between SQOL and the objective social participation measures of diversity, frequency (intensity) or proportion of activities performed outside of home. Conclusions: Findings contribute to the TBI literature in showing that it is: (a) the more subjective and not objectively measured nature of participation that is associated with SQOL and (b) positive and negative aspects of quality of life show different relationships with social participation variables.Implications for RehabilitationA high proportion of individuals with traumatic brain injury (TBI) experiences reduced involvement in social participation (involvement in social and leisure activities and within a social network) and low subjective quality of life (SQOL).This study suggests that, by simply increasing the variety and frequency of social and leisure activities, there may be no positive influences on SQOL.Instead, this study suggests that, to increase SQOL, it is important to increase opportunities for individuals to participate with others and also to enhance their subjective experience of social and leisure activities.The large variance obtained of scores for social participation and SQOL provide a reminder to clinicians to maintain an individualized approach when working with individuals with TBI.

Subjective quality of life in war-affected populations

BackgroundExposure to traumatic war events may lead to a reduction in quality of life for many years. Research suggests that these impairments may be associated with posttraumatic stress symptoms; however, wars also have a profound impact on social conditions. Systematic studies utilising subjective quality of life (SQOL) measures are particularly rare and research in post-conflict settings is scarce. Whether social factors independently affect SQOL after war in addition to symptoms has not been explored in large scale studies.MethodWar-affected community samples were recruited through a random-walk technique in five Balkan countries and through registers and networking in three Western European countries. The interviews were carried out on average 8 years after the war in the Balkans. SQOL was assessed on Manchester Short Assessment of Quality of Life - MANSA. We explored the impact of war events, posttraumatic stress symptoms and post-war environment on SQOL.ResultsWe interviewed 3313 Balkan residents and 854 refugees in Western Europe. The MANSA mean score was 4.8 (SD = 0.9) for the Balkan sample and 4.7 (SD = 0.9) for refugees. In both samples participants were explicitly dissatisfied with their employment and financial situation. Posttraumatic stress symptoms had a strong negative impact on SQOL. Traumatic war events were directly linked with lower SQOL in Balkan residents. The post-war environment influenced SQOL in both groups: unemployment was associated with lower SQOL and recent contacts with friends with higher SQOL. Experiencing more migration-related stressors was linked to poorer SQOL in refugees.ConclusionBoth posttraumatic stress symptoms and aspects of the post-war environment independently influence SQOL in war-affected populations. Aid programmes to improve wellbeing following the traumatic war events should include both treatment of posttraumatic symptoms and social interventions.

4．高所地域高齢者の健康

The health status of high-altitude population in Qinghai (China), Ladakh (India), and Arunachal (India) was investigated using comprehensive geriatric functional assessment in relation to their recent lifestyle change with the socio-economic globalization. People in urban areas had a higher prevalence of lifestyle-related diseases and poorer geriatric functions, and a lower subjective quality of life (QOL) than people in rural areas. The optimal prevention of lifestyle-related diseases and preservation of a high QOL are important for the people living in each of the above-mentioned areas with a high altitude.

A comparison of cognitive function, sleep and activity levels in disease-free breast cancer patients with or without cancer-related fatigue syndrome

BackgroundChronic fatigue is a feature in a subset of women successfully treated for breast cancer but is not well characterised. This study examines differences in objective cognitive function, activity levels...

Lower subjective quality of life and the development of social anxiety symptoms after the discharge of elderly patients with remitted schizophrenia: a 5-year longitudinal study

ObjectivesRemitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of “deinstitutionalization.” The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life. MethodsFifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization–Quality of Life 26 (WHO-QOL26). ResultsThirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms. ConclusionIn community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social anxiety may be needed.

A comparison of cognitive function and activity levels in disease-free breast cancer patients

BackgroundChronic fatigue is a feature in a subset of women successfully treated for breast cancer. The clinical features of this group are not well characterised. This study examines differences in...