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Health-Related Quality of Life, Functioning and Social Experiences in People with Psychotic Disorders

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Abstract

To inform development of a model for health-related quality of life (HRQoL) in people with psychotic disorders, we aimed to assess correlations between utilities and dimension scores for the Assessment of Quality of Life (AQoL)-4D with functioning and social experiences; ascertain if patient housing and clinical status affected correlations; and determine aspects of functioning that jointly predict HRQoL. We analyzed data for 1642 people with an ICD-10 psychotic disorder from the 2010 Australian National Survey of Psychosis. Global functioning was measured with the Personal and Social Performance scale, independent functioning with the Multidimensional Scale of Independent Functioning and social functioning through level of social dysfunction. Social experiences comprised perceived loneliness and experienced stigma. We assessed Spearman’s rank correlation coefficients and undertook linear regression analyses. Moderate associations were found between AQoL-4D utilities and all variables, except experienced stigma. Perceived loneliness had the strongest association. The AQoL-4D social relationships dimension was most strongly associated with social variables; its independent living dimension with global and independent functioning. Correlations between utilities and all variables, except for social dysfunction, were modified by housing. Course of disorder impacted correlations with utilities and independent functioning. Global functioning and social dysfunction were found to jointly predict HRQoL. In conclusion, as the AQoL-4D can differentiate between functioning and social experiences individually and when categorized by housing and clinical status in people with psychosis, predictive models of HRQoL in this population are feasible, and only need include select aspects of functioning and social experiences, particularly perception of loneliness.

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References

  • Aas, I. M. (2010). Global assessment of functioning (GAF): Properties and frontier of current knowledge. Annals of General Psychiatry, 9(1), 20.

    Article  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Association.

    Book  Google Scholar 

  • AQoL (2014). AQoL assessment of quality of life. www.aqol.com.au. Accessed 2016.

  • Breier, A., & Strauss, J. S. (1984). The role of social relationships in the recovery from psychotic disorders. The American Journal of Psychiatry, 141, 949–955.

    Article  Google Scholar 

  • Chrostek, A., Grygiel, P., Anczewska, M., Wciórka, J., & Świtaj, P. (2016). The intensity and correlates of the feelings of loneliness in people with psychosis. Comprehensive Psychiatry, 70, 190–199. https://doi.org/10.1016/j.comppsych.2016.07.015.

    Article  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: L. Erlbaum Associates.

    Google Scholar 

  • Downey, L. V. A., Zun, L. S., & Jones Gonzales, S. (2009). Utilization of emergency department by psychiatric patients. Primary Psychiatry, 16(4), 60.

    Google Scholar 

  • Fayers, P. M., & Machin, D. (2016). Quality of life: The assessment, analysis and reporting of patient-reported outcomes (3rd ed.). Chichester Sussex: Wiley Blackwell.

    Google Scholar 

  • Gray, A. J. (2002). Stigma in psychiatry. Journal of the Royal Society of Medicine, 95(2), 72–76.

    Article  Google Scholar 

  • Harvey, C., Evert, H., Herrman, H., Pinzone, T., & Gureje, O. (2002). Disability, homelessness and social relationships among people living with psychosis in Australia. National Survey of Mental Health and Wellbeing Bulletin (Vol. 5, pp. 92). Canberra Australia: Commonwealth Department of Health and Ageing.

  • Harvey, C., Killackey, E., Groves, A., & Herrman, H. (2012). A place to live: housing needs for people with psychotic disorders identified in the second Australian national survey of psychosis. Australian and New Zealand Journal of Psychiatry, 46(9), 840–850.

    Article  Google Scholar 

  • Hawthorne, G., & Osborne, R. (2005). Population norms and meaningful differences for the assessment of quality of life (AQoL) measure. Australian and New Zealand Journal of Public Health, 29(2), 136–142. https://doi.org/10.1111/j.1467-842X.2005.tb00063.x.

    Article  Google Scholar 

  • Hawthorne, G., Richardson, J., & Osborne, R. (1999). The assessment of quality of life (AQoL) instrument: a psychometric measure of health-related quality of life. Quality of Life Research, 8(3), 209–224. https://doi.org/10.1023/a:1008815005736.

    Article  Google Scholar 

  • Herrman, H., Hawthorne, G., & Thomas, R. (2002). Quality of life assessment in people living with psychosis. Social Psychiatry and Psychiatric Epidemiology, 37(11), 510–518. https://doi.org/10.1007/s00127-002-0587-y.

    Article  Google Scholar 

  • Holubova, M., Prasko, J., Latalova, K., Ociskova, M., Grambal, A., Kamaradova, D., Vrbova, K., & Hruby, R. (2016). Are self-stigma, quality of life, and clinical data interrelated in schizophrenia spectrum patients? A cross-sectional outpatient study. Patient Preference and Adherence, 10, 265–274.

    Article  Google Scholar 

  • Hosseini, S. H., & Yousefi, M. K. (2011). Quality of life and GAF in schizophrenia correlation between quality of life and global functioning in schizophrenia. Iranian Journal of Psychiatry and Behavioral Sciences, 5(2), 120–125.

    Google Scholar 

  • Hunter, R., & Barry, S. (2012). Negative symptoms and psychosocial functioning in schizophrenia: neglected but important targets for treatment. European Psychiatry, 27(6), 432–436.

    Article  Google Scholar 

  • Jaeger, J., Berns, S. M., & Czobor, P. (2003). The multidimensional scale of independent functioning: a new instrument for measuring functional disability in psychiatric populations. Schizophrenia Bulletin, 29(1), 153–168.

    Article  Google Scholar 

  • Kusel, Y., Laugharne, R., Perrington, S., McKendrick, J., Stephenson, D., Stockton-Henderson, J., Barley, M., McCaul, R., & Burns, T. (2007). Measurement of quality of life in schizophrenia: a comparison of two scales. Social Psychiatry and Psychiatric Epidemiology, 42(10), 819–823.

    Article  Google Scholar 

  • Lin, C.-Y., Chang, C.-C., Wu, T.-H., & Wang, J.-D. (2016). Dynamic changes of self-stigma, quality of life, somatic complaints, and depression among people with schizophrenia: a pilot study applying kernel smoothers. Stigma and Health, 1(1), 29–43. https://doi.org/10.1037/sah0000014.

    Article  Google Scholar 

  • McDaid, D., Bauer, A., & Park, A.-L. (2017). Making the economic case for investing in actions to prevent and/or tackle loneliness: A systematic review. London: Personal Social Services Research Unit London School of Economics and Political Science.

    Google Scholar 

  • Morgan, V. A., Waterreus, A., Jablensky, A., Mackinnon, A., McGrath, J. J., Carr, V., Bush, R., Castle, D., Cohen, M., Harvey, C., Galletly, C., Stain, H. J., Neil, A. L., McGorry, P., Hocking, B., Shah, S., & Saw, S. (2012). People living with psychotic illness in 2010: the second Australian national survey of psychosis. Australian and New Zealand Journal of Psychiatry, 46(8), 735–752. https://doi.org/10.1177/0004867412449877.

    Article  Google Scholar 

  • Morgan, V. A., McGrath, J. J., Jablensky, A., Badcock, J. C., Waterreus, A., Bush, R., Carr, V., Castle, D., Cohen, M., Galletly, C., Harvey, C., Hocking, B., McGorry, P., Neil, A. L., Saw, S., Shah, S., Stain, H. J., & Mackinnon, A. (2014). Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis. Psychological Medicine, 44(10), 2163–2176. https://doi.org/10.1017/s0033291713002973.

    Article  Google Scholar 

  • Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV social and occupational functioning assessment scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 101(4), 323–329.

    Article  Google Scholar 

  • Morphet, J., Innes, K., Munro, I., O’Brien, A., Gaskin, C. J., Reed, F., & Kudinoff, T. (2012). Managing people with mental health presentations in emergency departments: a service exploration of the issues surrounding responsiveness from a mental health care consumer and carer perspective. Australasian Emergency Nursing Journal, 15(3), 148–155. https://doi.org/10.1016/j.aenj.2012.05.003.

    Article  Google Scholar 

  • Neil, A. L., Carr, V. J., Mackinnon, A., Foley, D. L., & Morgan, V. A. (2018). Health-related quality of life in people living with psychotic illness and factors associated with its variation. Value in Health, 21(8), 1002–1009. https://doi.org/10.1016/j.jval.2018.02.012.

    Article  Google Scholar 

  • Nevarez-Flores, A. G., Sanderson, K., Breslin, M., Carr, V. J., Morgan, V. A., & Neil, A. L. (2019). Systematic review of global functioning and quality of life in people with psychotic disorders. Epidemiology and Psychiatric Sciences, 28(1), 31–44. https://doi.org/10.1017/s2045796018000549.

    Article  Google Scholar 

  • Petho, B., & Ban, T. A. (1988). DCR Budapest-Nashville in the diagnosis and classification of functional psychoses. Psychopathology, 21(4–5), 149–240.

    Google Scholar 

  • Ritsner, M., Kurs, R., Ratner, Y., & Gibel, A. (2005). Condensed version of the quality of life scale for schizophrenia for use in outcome studies. Psychiatry Research, 135(1), 65–75.

    Article  Google Scholar 

  • Stain, H. J., Galletly, C. A., Clark, S., Wilson, J., Killen, E. A., Anthes, L., Campbell, L. E., Hanlon, M. C., & Harvey, C. (2012). Understanding the social costs of psychosis: the experience of adults affected by psychosis identified within the second Australian national survey of psychosis. Australian and New Zealand Journal of Psychiatry, 46(9), 879–889. https://doi.org/10.1177/0004867412449060.

    Article  Google Scholar 

  • Tang, I. C., & Wu, H.-C. (2012). Quality of life and self-stigma in individuals with schizophrenia. Psychiatric Quarterly, 83(4), 497–507. https://doi.org/10.1007/s11126-012-9218-2.

    Article  Google Scholar 

  • World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical description and diagnostic guidelines. Geneva: WHO.

    Google Scholar 

  • World Health Organization. (1997). Programme on mental health: WHOQOL measuring quality of life. Geneva: WHO.

    Google Scholar 

Download references

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Authors and Affiliations

  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia

    Adriana G. Nevarez-Flores, Vera A. Morgan, Monique Breslin, Kristy Sanderson & Amanda L. Neil

  2. Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia

    Vera A. Morgan & Anna Waterreus

  3. Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Medical School, The University of Western Australia, Crawley, Western Australia, Australia

    Vera A. Morgan

  4. Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia

    Carol Harvey

  5. North Western Mental Health, Melbourne, Victoria, Australia

    Carol Harvey

  6. Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, St Vincent’s Hospital, Darlinghurst Sydney, New South Wales, Australia

    Vaughan J. Carr

  7. Department of Psychiatry, School of Clinical Sciences, Monash Medical Centre, Monash University, Clayton, Victoria, Australia

    Vaughan J. Carr

  8. School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK

    Kristy Sanderson

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  1. Adriana G. Nevarez-Flores
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  2. Vera A. Morgan
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  3. Carol Harvey
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  4. Monique Breslin
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  5. Vaughan J. Carr
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  6. Kristy Sanderson
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  7. Anna Waterreus
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  8. Amanda L. Neil
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Correspondence to Amanda L. Neil.

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Nevarez-Flores, A.G., Morgan, V.A., Harvey, C. et al. Health-Related Quality of Life, Functioning and Social Experiences in People with Psychotic Disorders. Applied Research Quality Life 16, 1767–1783 (2021). https://doi.org/10.1007/s11482-020-09845-y

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  • DOI: https://doi.org/10.1007/s11482-020-09845-y

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