Determinants of subjective quality of life in first-episode psychosis patients receiving specialized early intervention service in Hong Kong

Abstract

Subjective health-related quality of life (QoL) is an important outcome dimension in patients with schizophrenia and related psychoses, but is relatively less studied in the early stage of illness. We aimed to examine clinical and treatment-related correlates of subjective QoL in 159 Chinese patients who had received 2-years of treatment from a specialized early intervention service (EASY) in Hong Kong. This was part of a randomized-controlled trial evaluating the efficacy of 1-year extended early intervention for first-episode psychosis (FEP) and the analyses were based on data obtained at study entry. Standardized assessments encompassing premorbid adjustment, duration of untreated psychosis, symptomatology, functioning and medication treatments were conducted. SF36 was administered with mental and physical health summary (MCS and PCS) scores being computed as primary measures for QoL. Correlations and independent t-test were performed as appropriate followed by multiple linear regression analyses to determine predictors of MCS and PCS scores. Our results showed that positive symptoms, depression, social anxiety, akathisia and attitude toward antipsychotic independently predicted MCS score (Adjusted R2=0.48, F=26.44, p<0.001). PCS score was predicted by social anxiety and functional levels (Adjusted R2=0.12, F=11.55, p<0.001). In line with the literature, our study indicates that psychopathology, in particular depression and anxiety are the major determinants of subjective QoL in FEP patients. Clinical staff should also adequately address antipsychotic-induced extrapyramidal side-effects and patients’ negative attitudes toward medication treatment in order to further improve subjective QoL of patients in the early stage of illness.