Quality of life and functioning ability in subjects vulnerable to psychosis

Svirskis, Tanja; Korkeila, Jyrki; Heinimaa, Markus; Huttunen, Jukka; Ilonen, Tuula; Ristkari, Terja; Hietala, Jarmo; Syvälahti, Erkka; McGlashan, Thomas; Vahlberg, Tero; Salokangas, Raimo K.R.

doi:10.1016/j.comppsych.2006.10.008

« Previous Next »Comprehensive Psychiatry
Volume 48, Issue 2 , Pages 155-160, March 2007

Quality of life and functioning ability in subjects vulnerable to psychosis

Tanja Svirskis
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
- Psychiatric Clinic, Turku University Central Hospital, 20520 Turku, Finland
- Corresponding author. Department of Psychiatry, University of Turku, 20700 Turku, Finland. Tel.: + 358 2 269 2285; fax: +358 2 269 2528.
Jyrki Korkeila
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
- Turku Psychiatric Clinic, Turku Mental Health Centre, 20700 Turku, Finland
Markus Heinimaa
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
Jukka Huttunen
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
- Turku Psychiatric Clinic, Turku Mental Health Centre, 20700 Turku, Finland
Tuula Ilonen
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
Terja Ristkari
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
Jarmo Hietala
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
- Turku Psychiatric Clinic, Turku Mental Health Centre, 20700 Turku, Finland
- Turku PET Centre, Turku University Central Hospital, 20520 Turku, Finland
Erkka Syvälahti
- Department of Psychopharmacology, University of Turku, 20520 Turku, Finland
Thomas McGlashan
- Department of Psychiatry, Yale University, New Haven, CT 06159, USA
Tero Vahlberg
- Department of Biostatistics, University of Turku, 20520 Turku, Finland
Raimo K.R. Salokangas
- Department of Psychiatry, University of Turku, 20700 Turku, Finland
- Psychiatric Clinic, Turku University Central Hospital, 20520 Turku, Finland
- Turku Psychiatric Clinic, Turku Mental Health Centre, 20700 Turku, Finland

published online 05 January 2007.

Abstract

Background

It is well established that quality of life (QOL) and functioning ability are impaired in psychosis, especially schizophrenia. Little is known about QOL and functioning in subjects vulnerable to psychosis (VTP).

Method

Three samples of nonpsychotic subjects (first-degree relatives of psychotic or severely ill patients, treatment-seeking patients, and a random community sample, in all 133 subjects) were assessed by the Structured Interview for Prodromal Symptoms and their vulnerability to psychosis was defined by severity of lifetime psychotic-like positive symptoms (nonsymptomatic, symptomatic, VTP). Quality of life was assessed by the Heinrichs' Quality of Life Scale and the Global Assessment of Functioning Ability (GAF) was used to measure functioning. Variance of QOL and GAF was explained by vulnerability status and psychiatric symptoms.

Results

Quality of life and functioning ability decreased linearly as positive symptom intensity increased and was lowest in the VTP subjects when background factors were controlled for. In multivariate analysis, negative symptoms predicted low QOL/GAF scores in addition to vulnerability status that was based on positive symptoms.

Conclusion

Vulnerability to psychosis is associated with decreased QOL and impaired functioning ability. Although current diagnostic evaluation of patients at high risk of psychosis relies heavily on the occurrence of positive symptoms, negative symptoms seem to be strongly associated with QOL and functioning ability in VTP subjects. This should be taken into account when assessing putatively vulnerable patients and planning treatment interventions for them.