Neurocognitive predictors of objective and subjective quality of life in individuals with schizophrenia: a meta-analytic investigation.
Neurocognitive predictors of objective and subjective quality of life in individuals with schizophrenia: a meta-analytic investigation.
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DOI：
10.1093/schbul/sbq077
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发表时间：
2012-03
影响因子：
6.6
通讯作者：
Arielle W. Tolman;M. Kurtz
中科院分区：
文献类型：
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作者：
Arielle W. Tolman;M. Kurtz
生活质量（QOL）已被认为是精神分裂症治疗结果的一个关键领域，但其决定因素尚未得到很好的理解。最近的荟萃分析表明，症状与生活质量只有适度的关系（Eack SM, Newhill CE）。精神分裂症患者的精神症状和生活质量：一项荟萃分析精神分裂症，2007;33:1225-1237)。精神分裂症患者在基本神经认知测量中表现出1-2个SD缺陷，这些缺陷与社区功能（如就业和独立生活）的客观测量之间的联系已经得到了很好的证实。虽然社区功能的客观测量和生活质量的测量似乎密切相关，但研究神经认知变量预测精神分裂症患者生活质量的能力却产生了相互矛盾的结果。精神分裂症文献中相反发现的一个潜在解释是生活质量的客观和主观指标的互换使用。本研究采用荟萃分析的定量方法，分别阐明精神分裂症患者客观生活质量（即可观察到的、临床评价的）和主观生活质量（即患者满意度）的神经认知决定因素之间的关系。从相关数据库中汇总了20项研究（10项客观研究和10项主观研究），共1615名患者。加权效应量分析显示，结晶言语能力、工作记忆言语表学习、加工速度和执行功能与生活质量客观指标之间存在小-中度相关关系（d≤0.55）。相比之下，结果显示绝大多数神经认知测量和主观生活质量测量的关系不显著或成反比。讨论了调节变量及其对未来研究和治疗发展的影响。
Quality of life (QOL) has been recognized as a crucial domain of outcome in schizophrenia treatment, and yet its determinants are not well understood. Recent meta-analyses suggest that symptoms have only a modest relationship to QOL (Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007;33:1225-1237). Individuals with schizophrenia show 1-2 SD deficits on measures of elementary neurocognition, and links between these deficits and objective measures of community functioning (eg, employment and independent living) are well established. While objective measures of community functioning and measures of QOL would appear to be closely related, studies investigating the ability of neurocognitive variables to predict QOL in individuals with schizophrenia have yielded conflicting results. One potential explanation for opposing findings in the schizophrenia literature is the interchangeable use of objective and subjective indices of QOL. This study used quantitative methods of meta-analysis to clarify the relationship between neurocognitive determinants of objective QOL (ie, observable, clinician-rated) and subjective QOL (ie, patient satisfaction) separately in individuals with schizophrenia. A total of 20 studies (10 objective and 10 subjective) consisting of 1615 clients were aggregated from relevant databases. Weighted effect size analysis revealed that there were small-moderate relationships (d ≤ 0.55) between crystallized verbal ability, working memory verbal list learning, processing speed, and executive function and objective indices of QOL. In contrast, results revealed either nonsignificant or inverse relationships for the vast majority of neurocognitive measures and measures of subjective QOL. Moderating variables and implications for future research and treatment development are discussed.