Abstract
Background:
Understanding factors related to poor quality of life (QoL) and
self-rated health (SRH) in clinical high-risk (CHR) for psychosis is
important for both research and clinical applications. We investigated
the associations of both constructs with CHR symptoms, axis-I disorders,
and sociodemographic variables in a community sample.
Methods:
In total, 2683 (baseline) and 829 (3-year follow-up) individuals of
the Swiss Canton of Bern (age-at-baseline: 16–40 years) were interviewed
by telephone regarding CHR symptoms, using the Schizophrenia Proneness
Instrument for basic symptoms, the Structured Interview for
Psychosis-Risk Syndromes for ultra-high risk (UHR) symptoms, the
Mini-International Neuropsychiatric Interview for current axis-I
disorders, the Brief Multidimensional Life Satisfaction Scale for QoL,
and the 3-level EQ-5D for SRH.
Results:
In cross-sectional structural equation modelling, lower SRH was
exclusively significantly associated with higher age, male gender, lower
education, and somatoform disorders. Poor QoL was exclusively associated
only with eating disorders. In addition, both strongly interrelated
constructs were each associated with affective, and anxiety disorders,
UHR and, more strongly, basic symptoms. Prospectively, lower SRH was
predicted by lower education and anxiety disorders at baseline, while
poorer QoL was predicted by affective disorders at baseline.
Conclusions:
When present, CHR, in particular basic symptoms are already
distressful for individuals of the community and associated with poorer
subjective QoL and health. Therefore, the symptoms are clinically
relevant by themselves, even when criteria for a CHR state are not
fulfilled. Yet, unlike affective and anxiety disorders, CHR symptoms
seem to have no long-term influence on QoL and SRH.
Study of Life Stressors and Suicidal Intent of Suicidal Attempters with or Without Axis 1 Psychiatric Comorbidities: A Case Control Study