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Improved quality of life over one year is associated with improved adherence in patients with schizophrenia

Published online by Cambridge University Press:  15 April 2020

K.P. Hayhurst ,
R.J. Drake ,
J.A. Massie ,
G. Dunn ,
T.R.E. Barnes ,
P.B. Jones  and
S.W. Lewis
K.P. Hayhurst*
Affiliation:
Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, United Kingdom
R.J. Drake
Affiliation:
Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, United Kingdom
J.A. Massie
Affiliation:
Mental Health Unit, Laureate House, Manchester Mental Health & Social Care Trust, Wythenshawe Hospital, Southmoor Road, Manchester, United Kingdom
G. Dunn
Affiliation:
Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester, United Kingdom
T.R.E. Barnes
Affiliation:
Centre for Mental Health, Imperial College London, Charing Cross Campus, London, United Kingdom
P.B. Jones
Affiliation:
Department of Psychiatry & CPFT, University of Cambridge, Cambridge, United Kingdom
S.W. Lewis
Affiliation:
Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, M13 9PL, United Kingdom
*
*Corresponding author. Tel.: +44(0)161 275 8365; fax: +44(0)161 275 1668. E-mail address: [email protected] (K.P. Hayhurst).
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Abstract

Aim:

Quality of life (QoL) is increasingly considered an important outcome in health research. We wished to explore the determinants of change in QoL in patients with schizophrenia over the course of a one-year RCT.

Methods:

Predictors of change in observer-rated QoL (Quality of Life Scale: QLS) were assessed in 363 patients with schizophrenia during the CUtLASS clinical trial.

Results:

Change in QLS score over the course of a year correlated with change in psychotic and depressive symptoms and treatment adherence. Linear regression showed that improvement in QoL was predicted by reduction in negative and depressive symptoms and improvement in adherence rating. These three change scores together explained 38% of the variance in QLS change. Exploration of the direction of any possible causal effect, using TETRAD, indicated that improved adherence leads to improved QoL, and that change in depression also leads to QoL change. The relationship between QoL and negative symptoms suggests that greater social activity (reflected as better QoL scores) improves negative symptoms. Such a direct relationship between treatment adherence and QoL has not been reported before.

Conclusion:

Improving adherence to medication would appear to be a key approach to improving measured quality of life in people with schizophrenia.

Keywords

AdherenceDepressionQuality of lifeSchizophreniaSymptoms
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 3 , March 2014 , pp. 191 - 196
Copyright
Copyright © European Psychiatric Association 2014

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