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Health-related quality of life in outpatients with schizophrenia: factors that determine changes over time

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Abstract

Purpose

The objective of this study was to analyze the clinical factors associated with changes in HRQoL in outpatients with schizophrenia using both generic and condition-specific HRQoL scales.

Methods

Adult outpatients with schizophrenia at least 18 years of age who did not have an acute psychotic exacerbation in the 3 months prior to baseline were recruited. PANSS dimensions were calculated based on Lindenmayer et al.’s five factors. HRQoL data were assessed by patients using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D) questionnaires.

Results

Out of the 1345 patients included at baseline, 1196 (89%) were evaluated at 12 months. Regression models showed that the factor most consistently associated with HRQoL at endpoint was change in the PANSS negative symptoms score. A decrease in the PANSS negative symptoms score from baseline to 1 year was associated with a decrease in HRQoL during the same period. There were also significant associations of the change in PANSS excitatory factor with all the HRQoL scales except the SF-36 PCS. Female gender was associated with a decrease in all HRQoL ratings. There was also a relationship between years since onset and HRQoL. The longer the time since illness onset, the larger the decrease in HRQoL.

Conclusions

This study has found that, in outpatients with schizophrenia, changes in negative and excitement symptoms may have a greater an association with HRQoL than changes in positive, cognitive and depressive symptoms.

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Funding

The Pattern Study was funded by F. Hoffmann-La Roche Ltd, Basel, Switzerland, who freely provided the database to the authors. The statistical analyses and the manuscript were produced independently of Roche.

Author information

Authors and Affiliations

  1. Universitat de Barcelona, Barcelona, Spain

    Cristina Domenech & Josep Maria Haro

  2. Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain

    Cristina Domenech & Josep Maria Haro

  3. University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milano, Italy

    Carlo Altamura

  4. Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM), Cerviño 4634 5th Floor Apt. B, C1425AHQ, Buenos Aires, Argentina

    Ricardo Corral

  5. Departamento e Instituto de Psiquiatria-FMUSP, Sao Paulo, Brazil

    Helio Elkis

  6. Centre for Academic Mental Health, University of Bristol, Bristol, BS8 2BN, UK

    Jonathan Evans

  7. Douglas Mental Health University Institute, McGill University, Montréal, QC, H4H 1R3, Canada

    Ashok Malla

  8. Service Hospitalo Universitaire, Laboratoire de Physiopathologie des Maladies Psychiatriques, Inserm, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France

    Marie-Odile Krebs

  9. Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Mathias Zink

  10. Regional Clinical Centre, Ansbach, Germany

    Mathias Zink

  11. F. Hoffmann-La Roche Ltd, Basel, Switzerland

    Corrado Bernasconi & Anna-Lena Nordstroem

Authors
  1. Cristina Domenech
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  2. Carlo Altamura
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  3. Corrado Bernasconi
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  4. Ricardo Corral
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  5. Helio Elkis
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  6. Jonathan Evans
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  7. Ashok Malla
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  8. Marie-Odile Krebs
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  9. Anna-Lena Nordstroem
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  10. Mathias Zink
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  11. Josep Maria Haro
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Corresponding author

Correspondence to Josep Maria Haro.

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Conflict of interest

Cristina Domenech has no conflict of interest. Carlo Altamura has served as a consultant or advisory board member for F. Hoffmann-La Roche, Ltd., Lundbeck, Merck, Astra Zeneca, Bristol Myers Squibb, Janssen-Cilag, Sanofi, Eli Lilly, Pfizer and Otsuka. Corrado Bernasconi is a contractor of F. Hoffmann-La Roche, Ltd. Helio Elkis has received research grants from the São Paulo Research Foundation (FAPESP), Janssen-Cilag and Roche, participated on advisory boards for Janssen-Cilag and Roche, and received honoraria and travel support from Janssen-Cilag and Roche. Ashok Malla has received honoraria or participated in advisory boards or educational conferences or received research funding for investigator-initiated projects from Janssen Canada, Pfizer Canada, Bristol-Myers-Squib, F. Hoffmann- La Roche, Ltd., Otsuka, Lundbeck and Astra-Zeneca. Anna-Lena Nordstroem is an employee of F. Hoffmann-La Roche, Ltd. Mathias Zink has received unrestricted scientific grants from the European Research Advisory Board, German Research Foundation, Servier, Pfizer Pharma GmbH, Bristol-Myers Squibb GmbH & CoKGaA, and speaker and travel support from Pfizer Pharma GmbH, Bristol-Myers Squibb, Otsuka, Astra Zeneca, Eli-Lilly, Janssen Cilag, Servier, Trommsdorff and F. Hoffmann-La Roche Ltd. Marie-Odile Krebs has received honoraria from and participated in advisory boards for F. Hoffmann-La Roche, Ltd. Josep Maria Haro has acted as a consultant, participated in advisory boards or given educational presentations for Eli Lilly and Co., Lundbeck, Otsuka, F. Hoffmann-La Roche Ltd. and Takeda. Jonathan Evans and Ricardo Corral have no conflicts of interest.

Informed consent

The protocol and consent procedures were approved by all local institute review boards/ethics committees before study initiation. All patients and caregivers provided informed consent.

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Domenech, C., Altamura, C., Bernasconi, C. et al. Health-related quality of life in outpatients with schizophrenia: factors that determine changes over time. Soc Psychiatry Psychiatr Epidemiol 53, 239–248 (2018). https://doi.org/10.1007/s00127-018-1483-4

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