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Quality of life in first episode psychosis: a cluster analytic approach



Quality of life is increasingly recognised as an important outcome for young people with first episode psychosis (FEP). The first aim was to determine whether distinct homogenous subgroups of young people with FEP could be delineated based on profiles on quality of life domains (Physical Health, Psychological, Social relationships and Environmental). The second aim was to examine the discriminant validity of these subgroups with respect to demographic, functioning and clinical features of FEP.


Quality of life, demographic characteristics, clinical characteristics, cognition and functioning were assessed in 145 people with FEP. Cluster analysis using Ward’s methods and Squared Euclidean Distance with a k-means verification were employed to identify subgroups with homogenous quality of life profiles. The clusters were externally validated using multinomial logistic regressions.


Three distinct quality of life profiles were identified: one with good quality of life across all domains (30%), one with poor quality of life particularly in Psychological and Social relationships domains (28%), and one ‘intermediate’ group with comparatively low Psychological quality of life (42%). Depression, semantic verbal fluency, social inclusion and social/occupational functioning showed associations with group membership.


Our results suggest the potential of maintaining relatively good quality of life despite the experience of FEP. Future research on interventions to improve quality of life may consider the potential of addressing depression, social inclusion and social/occupational functioning.

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Data availability

Data might be available on request and after appropriate institutional agreements and ethics approvals.


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This work was supported by Australian Rotary Health; the Australian Research Council (LP0883273); Orygen, The National Centre of Excellence in Youth Mental Health; National Health and Medical Research Council Career Development Fellowships to KA (APP1141207) and to EK (APP1051891); National Health and Medical Research Council Senior Research Fellowship SC (APP1136344). The funding source had no role in the design and outcome of the study.

Author information




EK, KA and SC were involved in the design and data collection of the original study from which the current study is based on. KA, SC, JA and ZL contributed to the design of the current study. ZL was responsible for data analysis and drafting of the manuscript. All authors revised and provided critical feedback for the manuscript. All authors agree to be accountable for all aspects of the work and ensure issues regarding the accuracy or integrity of the work is addressed and resolved.

Corresponding author

Correspondence to S. M. Cotton.

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Institutional ethics approval was given by Melbourne Health Human Research and Ethics Committee. All young people (and their guardians if under 18 years of age) provided written informed consent to participate in the study.

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Liao, Z., Allott, K., Anderson, J.F.I. et al. Quality of life in first episode psychosis: a cluster analytic approach. Qual Life Res (2021).

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  • Quality of life
  • First episode psychosis
  • Cluster analysis
  • Depression