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Systematic review of global functioning and quality of life in people with psychotic disorders

Published online by Cambridge University Press:  01 October 2018

A. G. Nevarez-Flores Open the ORCID record for A. G. Nevarez-Flores [Opens in a new window] ,
K. Sanderson ,
M. Breslin ,
V. J. Carr ,
V. A. Morgan  and
A. L. Neil Open the ORCID record for A. L. Neil [Opens in a new window]
A. G. Nevarez-Flores
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia
K. Sanderson
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia School of Health Sciences, University of East Anglia. Norwich Research Park Norwich, NR4 7TJ, UK
M. Breslin
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia
V. J. Carr
Affiliation:
Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, St Vincent's Hospital, Sydney, New South Wales, Australia Department of Psychiatry, School of Clinical Sciences, Monash Medical Centre, Monash University, Clayton Melbourne, Victoria, Australia
V. A. Morgan
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Medical School, The University of Western Australia, Crawley, Western Australia, Australia
A. L. Neil*
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia
*
Author for correspondence: Dr Amanda L. Neil, E-mail: [email protected]
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Abstract

Aims

People with psychotic disorders face impairments in their global functioning and their quality of life (QoL). The relationship between the two outcomes has not been systematically investigated. Through a systematic review, we aim to explore the presence and extent of associations between global functioning and QoL and establish whether associations depend on the instruments employed.

Methods

In May 2016, ten electronic databases were searched using a two-phase process to identify articles in which associations between global functioning and QoL were assessed. Basic descriptive data and correlation coefficients between global functioning and QoL instruments were extracted, with the strength of the correlation assessed according to the specifications of Cohen 1988. Results were reported with reference to the Meta-analysis of Observational Studies in Epidemiology guidelines and PRISMA standards. A narrative synthesis was performed due to heterogeneity in methodological approaches.

Results

Of an initial 15 183 non-duplicate articles identified, 756 were deemed potentially relevant, with 40 studies encompassing 42 articles included. Fourteen instruments for measuring global functioning and 22 instruments for measuring QoL were used. Twenty-nine articles reported linear associations while 19 assessed QoL predictors. Correlations between overall scores varied in strength, primarily dependent on the QoL instrument employed, and whether QoL was objectively or subjectively assessed. Correlations observed for objective QoL measures were consistently larger than those observed for subjective measures, as were correlations for an interviewer than self-assessed QoL. When correlations were assessed by domains of QoL, the highest correlations were found for social domains of QoL, for which most correlations were moderate or higher. Global functioning consistently predicted overall QoL as did depressive and negative symptoms.

Conclusions

This review is the first to explore the extent of associations between global functioning and QoL in people with psychotic disorders. We consistently found a positive association between global functioning and QoL. The strength of the association was dependent on the QoL instrument employed. QoL domains strongly associated with global functioning were highlighted. The review illustrates the extensive array of instruments used for the assessment of QoL and to a lesser extent global functioning in people with psychotic disorders and provides a framework to understand the different findings reported in the literature. The findings can also inform the future choice of instruments by researchers and/or clinicians. The observed associations reassure that interventions for improving global functioning will have a positive impact on the QoL of people living with a psychotic disorder.

Keywords

Functioningpsychosisquality of lifeSchizophrenia
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 1 , February 2019 , pp. 31 - 44
Copyright
Copyright © Cambridge University Press 2018 

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References

Aas, IM (2010) Global Assessment of Functioning (GAF): properties and frontier of current knowledge. Annals of General Psychiatry 9, 20.Google Scholar
Adewuya, AO and Makanjuola, ROA (2009) Subjective quality of life of Nigerian schizophrenia patients: sociodemographic and clinical correlates. Acta Psychiatrica Scandinavica 120, 160–164.Google Scholar
Akinsulore, A, Aloba, OO, Mapayi, BM, Oloniniyi, IO, Fatoye, FO and Makanjuola, RO (2014) Relationship between depressive symptoms and quality of life in Nigerian patients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology 49, 1191–1198.Google Scholar
Alessandrini, M, Lançon, C, Fond, G, Faget-Agius, C, Richieri, R, Faugere, M, Metairie, E, Boucekine, M, Llorca, PM, Auquier, P and Boyer, L (2016) A structural equation modelling approach to explore the determinants of quality of life in schizophrenia. Schizophrenia Research 171, 27–34.Google Scholar
Ascher-Svanum, H, Novick, D, Haro, JM, Aguado, J and Cui, Z (2013). Empirically driven definitions of “good,” “moderate,” and “poor” levels of functioning in the treatment of schizophrenia. Quality of Life Research 22, 2085–2094.Google Scholar
Atkinson, M, Zibin, S and Chuang, H (1997) Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. American Journal of Psychiatry 154, 99–105.Google Scholar
Awad, AG, Voruganti, LN and Heslegrave, RJ (1997) Measuring quality of life in patients with schizophrenia. PharmacoEconomics 11, 32–47.Google Scholar
Bai, YM, Hsiao, CY, Chen, KC, Huang, KL, Lee, IH, Hsu, JW, Chen, PS and Yang, YK (2014) The development of a self-reported scale for measuring functionality in patients with schizophrenia-Self-reported version of the graphic Personal and Social Performance (SRG-PSP) scale. Schizophrenia Research 159, 546–551.Google Scholar
Baker, F and Intagliata, J (1982) Quality of life in the evaluation of community support systems. Evaluation and Program Planning 5, 69–79.Google Scholar
Becker, T, Leese, M, Krumm, S, Ruggeri, M and Vazquez-Barquero, JL (2005) Needs and quality of life among patients with schizophrenia in five European centres: what is the impact of global functioning scores? Social Psychiatry and Psychiatric Epidemiology 40, 628–634.Google Scholar
Bellack, AS, Green, MF, Cook, JA, Fenton, W, Harvey, PD, Heaton, RK, Laughren, T, Leon, AC, Mayo, DJ, Patrick, DL, Patterson, TL, Rose, A, Stover, E and Wykes, T (2007) Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop. Schizophrenia Bulletin 33, 805–822.Google Scholar
Ben-Zur, H, Duvdevany, I and Saffoury Issa, D (2014) Ethnicity moderates the effects of resources on quality of life for persons with mental illness living in community settings. Psychiatric Rehabilitation Journal 37, 309–315.Google Scholar
Bengtsson-Tops, A, Hansson, L, Sandlund, M, Bjarnason, O, Korkeila, J, Merinder, L, Nilsson, L, Sørgaard, KW, Vinding, HR and Middelboe, T (2005) Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study. Quality of Life Research 14, 221–229.Google Scholar
Bowling, A (2005) Measuring Health: a Review of Quality of Life Measurement Scales. Berkshire, England: Open University Press.Google Scholar
Brissos, S, Balanza-Martinez, V, Dias, VV, Carita, AI and Figueira, ML (2011) Is personal and social functioning associated with subjective quality of life in schizophrenia patients living in the community? European Archives of Psychiatry & Clinical Neuroscience 261, 509–517.Google Scholar
Browne, S, Roe, M, Lane, A, Gervin, M, Morris, M, Kinsella, A, Larkin, C and O'Callaghan, E (1996) Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiatrica Scandinavica 94, 118–124.Google Scholar
Caqueo-Urízar, A, Urzúa, A, Boyer, L, Williams, D, Caqueo-Urízar, A, Urzúa, A and Williams, DR (2016) Religion involvement and quality of life in patients with schizophrenia in Latin America. Social Psychiatry and Psychiatric Epidemiology 51, 521–528.Google Scholar
Caron, J, Lecomte, Y, Stip, E and Renaud, S (2005) Predictors of quality of life in schizophrenia. Community Mental Health Journal 41, 399–417, 19p.Google Scholar
Chan, GWL, Ungvari, GS, Shek, DTL and Leung, JJP (2003) Hospital and community-based care for patients with chronic schizophrenia in Hong Kong quality of life and its correlates. Social Psychiatry & Psychiatric Epidemiology 38, 196–203.Google Scholar
Chino, B, Nemoto, T, Fujii, C and Mizuno, M (2009) Subjective assessments of the quality of life, well-being and self-efficacy in patients with schizophrenia: regular article. Psychiatry and Clinical Neurosciences 63, 521–528.Google Scholar
Cohen, J (1988) Statistical Power Analysis for the Behavioral Sciences L. Hillsdale, New Jersey: Erlbaum Associates.Google Scholar
Cohen, CI, Jimenez, C and Mittal, S (2010) The role of religion in the well-being of older adults with schizophrenia. Psychiatric Services 61, 917–922.Google Scholar
Dima, L, Vasile, D, Rogozea, L, Zia-Ul-Haq, M, Bukhari, SA and Moga, M (2015) Self-perception of quality of life in patients treated with antipsychotics. Turkish Journal of Medical Sciences 45, 782–788.Google Scholar
Elkinton, JR (1966) Medicine and the quality of life. Annals of Internal Medicine 64, 711–714.Google Scholar
Fayers, PM and Machin, D (2016) Quality of Life: The Assessment, Analysis and Reporting of Patient-Reported Outcomes. Chichester, Sussex UK: Wiley Blackwell.Google Scholar
Fricker, S, Yan, T and Tsai, S (2014) Response burden: what predicts it and who is burdened out? In AAPOR Proceedings, American Association for Public Opinion Research, Anaheim, California, May 15–18, 2014, pp. 4568–4577.Google Scholar
Fujino, H, Sumiyoshi, C, Sumiyoshi, T, Yasuda, Y, Yamamori, H, Ohi, K, Fujimoto, M, Hashimoto, R, Takeda, M and Imura, O (2016) Predicting employment status and subjective quality of life in patients with schizophrenia. Schizophrenia Research: Cognition 3, 20–25.Google Scholar
Gaite, L, Vazquez-Barquero, JL, Borra, C, Ballesteros, J, Schene, A, Welcher, B, Thornicroft, G, Becker, T, Ruggeri, M and Herran, A (2002) Quality of life in patients with schizophrenia in five European countries: the EPSILON study. Acta Psychiatrica Scandinavica 105, 283–292.Google Scholar
Galuppi, A, Turola, MC, Nanni, MG, Mazzoni, P and Grassi, L (2010) Schizophrenia and quality of life: how important are symptoms and functioning? International Journal of Mental Health Systems 4, 31.Google Scholar
Greenley, JR, Greenberg, JS and Brown, R (1997) Measuring quality of life: a new and practical survey instrument. Social Work 42, 244–254.Google Scholar
Grover, S, Davuluri, T and Chakrabarti, S (2014) Religion, spirituality, and schizophrenia: a review. Indian Journal of Psychological Medicine 36, 119.Google Scholar
Guilera, G, Gomez-Benito, J, Pino, O, Rojo, JE, Cuesta, MJ, Martinez-Aran, A, Safont, G, Tabares-Seisdedos, R, Vieta, E, Bernardo, M, Crespo-Facorro, B, Franco, M and Rejas, J (2012) Utility of the World Health Organization Disability Assessment Schedule II in schizophrenia. Schizophrenia Research 138, 240–247.Google Scholar
Harvey, PD (2014). What is the evidence for changes in cognition and functioning over the lifespan in patients with schizophrenia? The Journal of Clinical Psychiatry 75(Suppl. 2), 34–38.Google Scholar
Harvey, PD and Davidson, M (2002) Schizophrenia: Course Over the Lifetime. In Neuropsychopharmacology: The Fifth Generation of Progress (ed. Davis, KL, Charney, D, Coyle, JT and Nemeroff, C), pp. 641–655. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Heinrichs, DW, Hanlon, TE and Carpenter, WT (1984) The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin 10, 388–398.Google Scholar
Holloway, F and Carson, J (1999) Subjective quality of life, psychopathology, satisfaction with care and insight: an exploratory study. International Journal of Social Psychiatry 45, 259–267.Google Scholar
Hosseini, SH and Yousefi, MK (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, 120–125.Google Scholar
Hunter, R and Barry, S (2012) Negative symptoms and psychosocial functioning in schizophrenia: neglected but important targets for treatment. European Psychiatry 27, 432–436.Google Scholar
Ito, S, Nemoto, T, Tsujino, N, Ohmuro, N, Matsumoto, K, Matsuoka, H, Tanaka, K, Nishiyama, S, Suzuki, M, Kinoshita, H, Ozawa, H, Fujita, H, Shimodera, S, Kishimoto, T, Matsumoto, K, Hasegawa, T and Mizuno, M (2015) Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset. European Psychiatry 30, 995–1001.Google Scholar
Karadayi, G, Emiroglu, B and Ucok, A (2011) Relationship of symptomatic remission with quality of life and functionality in patients with schizophrenia. Comprehensive Psychiatry 52, 701–707.Google Scholar
König, H-H, Roick, C and Angermeyer, MC (2007) Validity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders. European Psychiatry 22, 177–187.Google Scholar
Kuo, PJ, Ma, HI, Kuo, CC, Huang, WC and Chung, MS (2009) Factor analysis of the schizophrenia quality of life scale revision 4 (SQLS-R4) Chinese version and related factors. International Journal of Psychiatry in Clinical Practice 13, 278–284.Google Scholar
Kusel, Y, Laugharne, R, Perrington, S, McKendrick, J, Stephenson, D, Stockton-Henderson, J, Barley, M, McCaul, R and Burns, T (2007) Measurement of quality of life in schizophrenia: a comparison of two scales. Social Psychiatry and Psychiatric Epidemiology 42, 819–823.Google Scholar
Lasebikan, VO and Owoaje, ET (2015) Quality of life in psychosis: prevalence and associated factors in a Nigerian clinical population. Community Mental Health Journal 51, 491–496.Google Scholar
Lehman, AF (1988) A quality of life interview for the chronically mentally ill. Evaluation and Program Planning 11, 51–62.Google Scholar
Lehman, AF (1995) Demographic influences on quality of life among persons with chronic mental illnesses. Evaluation and Program Planning 18, 155–164.Google Scholar
Mas-Exposito, L, Amador-Campos, JA, Gomez-Benito, J and Lalucat-Jo, L (2011) The World Health Organization Quality of Life Scale Brief Version: a validation study in patients with schizophrenia. Quality of life Research 20, 1079–1089.Google Scholar
Medeiros-Ferreira, L, Obiols, JE, Navarro-Pastor, JB and Zuniga-Lagares, A (2013) Metabolic syndrome and health-related quality of life in patients with schizophrenia. Actas Espanolas de Psiquiatria 41, 17–26.Google Scholar
Meijer, CJ, Schene, AH and Koeter, MW (2002) Quality of life in schizophrenia measured by the MOS SF-36 and the Lancashire Quality of Life Profile: a comparison. Acta Psychiatrica Scandinavica 105, 293–300.Google Scholar
Meijer, CJ, Koeter, MW, Sprangers, MA and Schene, AH (2009) Predictors of general quality of life and the mediating role of health related quality of life in patients with schizophrenia. Social Psychiatry & Psychiatric Epidemiology 44, 361–368.Google Scholar
Miclutia, IV, Popescu, CA and Macrea, RS (2008) Sexual dysfunctions of chronic schizophrenic female patients. Sexual & Relationship Therapy 23, 119–129.Google Scholar
Moher, D, Liberati, A, Tetzlaff, J and Altman, DG, and the PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine 151, 264–269.Google Scholar
Mubarak, AR (2005) Social functioning and quality of life of people with schizophrenia in the northern region of Malaysia. Australian e-Journal for the Advancement of Mental Health 4, 1–10.Google Scholar
Nafees, B, van Hanswijck de Jonge, P, Stull, D, Pascoe, K, Price, M, Clarke, A and Turkington, D (2012) Reliability and validity of the Personal and Social Performance scale in patients with schizophrenia. Schizophrenia Research 140, 71–76.Google Scholar
Norman, RMG, Malla, AK, McLean, T, Voruganti, LPN, Cortese, L, McIntosh, E, Cheng, S and Rickwood, A (2000) The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale. Acta Psychiatrica Scandinavica 102, 303–309.Google Scholar
Patterson, TL, Goldman, S, McKibbin, CL, Hughs, T and Jeste, DV (2001) UCSD performance-based skills assessment: development of a new measure of everyday functioning for severely mentally Ill adults. Schizophrenia Bulletin 27, 235–245.Google Scholar
Petho, B and Ban, TA (1988) DCR Budapest-Nashville in the diagnosis and classification of functional psychoses. Psychopathology 21, 149–240.Google Scholar
Pinikahana, J, Happell, B, Hope, J and Keks, NA (2002) Quality of life in schizophrenia: a review of the literature from 1995 to 2000. International Journal of Mental Health Nursing 11, 103–111.Google Scholar
Pitkanen, A, Valimaki, M, Endicott, J, Katajisto, J, Luukkaala, T, Koivunen, M, Kuosmanen, L and Hatonen, H (2012) Assessing quality of life in patients with schizophrenia in an acute psychiatric setting: reliability, validity and feasibility of the EQ-5D and the Q-LES-Q. Nordic Journal of Psychiatry 66, 19–25.Google Scholar
Prigent, A, Simon, S, Durand-Zaleski, I, Leboyer, M and Chevreul, K (2014) Quality of life instruments used in mental health research: properties and utilization. Psychiatry Research 215, 1–8.Google Scholar
Prince, JD (2007) Education, ethnicity, and subjective life quality of recently discharged inpatients with schizophrenia. Journal of Nervous & Mental Disease 195, 560–565.Google Scholar
PROSPERO: International prospective register of systematic reviews. Centre for Reviews and Dissemination, University of York. (http://www.crd.york.ac.uk). Accessed 13 August 2018.Google Scholar
Razali, SM and Wahid, MA (2012) Quality of life and depressive symptoms in patients with schizophrenia. International Medical Journal 19, 130–134.Google Scholar
Reine, G, Simeoni, MC, Auquier, P, Loundou, A, Aghababian, V and Lancon, C (2005) Assessing health-related quality of life in patients suffering from schizophrenia: a comparison of instruments. European Psychiatry 20, 510–519.Google Scholar
Riedel, M, Spellmann, I, Schennach-Wolff, R, Obermeier, M and Musil, R (2011) The RSM-scale: a pilot study on a new specific scale for self- and observer-rated quality of life in patients with schizophrenia. Quality of Life Research 20, 263–272.Google Scholar
Ritsner, M, Kurs, R, Ratner, Y and Gibel, A (2005) Condensed version of the Quality of Life Scale for schizophrenia for use in outcome studies. Psychiatry Research 135, 65–75.Google Scholar
Rocca, P, Montemagni, C, Zappia, S, Pitera, R, Sigaudo, M and Bogetto, F (2014) Negative symptoms and everyday functioning in schizophrenia: a cross-sectional study in a real world-setting. Psychiatry Research 218, 284–289.Google Scholar
Rocca, P, Montemagni, C, Mingrone, C, Crivelli, B, Sigaudo, M and Bogetto, F (2016) A cluster-analytical approach toward real-world outcome in outpatients with stable schizophrenia. European Psychiatry 32, 48–54.Google Scholar
Roe, D, Mashiach-Eizenberg, M and Lysaker, PH (2011) The relation between objective and subjective domains of recovery among persons with schizophrenia-related disorders. Schizophrenia Research 131, 133–138.Google Scholar
Sainfort, F, Becker, M and Diamond, R (1996) Judgments of quality of life of individuals with severe mental disorders: patient self-report versus provider perspectives. The American Journal of Psychiatry 153, 497–502.Google Scholar
Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D, Moher, D, Becker, BJ, Sipe, TA and Thacker, SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Journal of the American Medical Association 283, 2008–2012.Google Scholar
Stubbs, B, Gardner-Sood, P, Smith, S, Ismail, K, Greenwood, K, Patel, A, Farmer, R and Gaughran, F (2015) Pain is independently associated with reduced health related quality of life in people with psychosis. Psychiatry Research 230, 585–591.Google Scholar
Taft, C, Karlsson, J and Sullivan, M (2001) Do SF-36 summary component scores accurately summarize subscale scores? Quality of Life Research 10, 395–404.Google Scholar
The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine 28, 551–558.Google Scholar
Ulrich, CM, Wallen, GR, Feister, A and Grady, C (2005) Respondent burden in clinical research: when are we asking too much of subjects? IRB: Ethics & Human Research 27, 17–20.Google Scholar
von Elm, E, Altman, DG, Egger, M, Pocock, SJ, Gøtzsche, PC and Vandenbroucke, JP (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Bulletin of the World Health Organization 85, 867–872.Google Scholar
Ware, JE Jr, Kosinski, M, Bayliss, MS, McHorney, CA, Rogers, WH and Raczek, A (1995). Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Medical Care 33, AS264-AS279.Google Scholar
Woon, PS, Chia, MY, Chan, WY and Sim, K (2010) Neurocognitive, clinical and functional correlates of subjective quality of life in Asian outpatients with schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry 34, 463–468.Google Scholar
World Health Organization. Division of Mental Health and Prevention of Substance Abuse (1997) WHOQOL : measuring quality of life. Geneva: World Health Organization. http://www.who.int/iris/handle/10665/63482Google Scholar
World Health Organization. Division of Mental Health and Prevention of Substance Abuse (1998) Programme on mental health: WHOQOL user manual. Geneva: WHO.Google Scholar
World Health Organization (2001) International Classification of Functioning, Disability and Health: ICF. Geneva: WHO.Google Scholar
Zendjidjian, XY, Baumstarck, K, Auquier, P, Loundou, A, Lançon, C and Boyer, L (2014) Satisfaction of hospitalized psychiatry patients: why should clinicians care? Patient Preference and Adherence 8, 575–583.Google Scholar
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