Quality of life in first-episode psychotic patients: a study of its relationship with insight

Abstract

BACKGROUND: The concept of quality of life (QOL) in psychotic patients has aroused increasing attentions in recent years. However, few studies addressed the QOL of first-episode psychotic patients in the period of untreated psychosis. Apart from symptomatology, the correlation between QOL and the insight of patients remained unclear. METHODS: This study made a cross-sectional assessment on fifty-three first-episode psychotic patients (mean age 21.4 years old) when they first presented to the psychiatric service. Their QOL was assessed with the Chinese version of MOS 36 item Short Form Health Survey (SF-36) and the World Health Organization Quality of Life Measure, abbreviated version (WHOQOL-BREF(HK)). Insight of the patients was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD). RESULTS: Patients who were classified as having unimpaired insight according to their SUMD global score were found to have significantly poorer QOL in the General health and Role limitation due to emotional problems scales of SF-36 than those with impaired insight (p < 0.05). The SUMD awareness scores of patients were found to have more significant correlations with various QOL domains (p = 0.01 to 0.03) than the SUMD attribution scores. Both depression scores and SUMD awareness scores were found to be significant predictors of QOL, but they accounted for only a small proportion of the variance in regression analysis. CONCLUSION: There was an inverse correlation between level of insight and QOL in first-episode psychotic patients. The aspect of symptom awareness was more important than symptom attribution in accounting for the correlation.