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Article Dans Une Revue Psychological Medicine Année : 2020

The puzzle of quality of life in schizophrenia: putting the pieces together with the FACE-SZ cohort

1 HANDIReSP - Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur
2 CHV - Centre Hospitalier de Versailles André Mignot
3 CESP - Centre de recherche en épidémiologie et santé des populations
4 Fondation FondaMental [Créteil]
5 Département de psychiatrie adulte
6 Centre hospitalier Charles Perrens [Bordeaux]
7 NutriNeuro - Nutrition et Neurobiologie intégrée
8 NCPS - Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie
9 Les Hôpitaux Universitaires de Strasbourg (HUS)
10 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
11 Centre Hospitalier le Vinatier [Bron]
12 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique
13 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
14 CHU Clermont-Ferrand
15 Hôpital Louis Mourier - AP-HP [Colombes]
16 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
17 UPD7 - Université Paris Diderot - Paris 7
18 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
19 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
20 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
21 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
22 INCIA - Institut de Neurosciences cognitives et intégratives d'Aquitaine
23 IMRB - Institut Mondor de Recherche Biomédicale
24 UPEC Médecine - Université Paris-Est Créteil Val-de-Marne - Faculté de médecine
25 PSYR2 - Psychiatric Disorders, Neuroscience Research and Clinical Research
26 U955 Inserm - UPEC - IMRB - "Neuropsychiatrie translationnelle" [Créteil]
27 CHU Henri Mondor - Département de neurosciences
Face-Scz Group
  • Fonction : Auteur

Résumé

Background The determinants of quality of life (QoL) in schizophrenia are largely debated, mainly due to methodological discrepancies and divergence about the concepts concerned. As most studies have investigated bi- or tri-variate models, a multivariate model accounting for simultaneous potential mediations is necessary to have a comprehensive view of the determinants of QOL. We sought to estimate the associations between cognitive reserve, cognition, functioning, insight, depression, schizophrenic symptoms, and QoL in schizophrenia and their potential mediation relationships. Methods We used structural equation modeling with mediation analyses to test a model based on existing literature in a sample of 776 patients with schizophrenia from the FondaMental Foundation FACE-SZ cohort. Results Our model showed a good fit to the data. We found better functioning to be positively associated with a better QoL, whereas better cognition, better insight, higher levels of depression, and schizophrenic symptoms were associated with a lower QoL in our sample. Cognitive reserve is not directly linked to QoL, but indirectly in a negative manner via cognition. We confirm the negative relationship between cognition and subjective QoL which was previously evidenced by other studies; moreover, this relationship seems to be robust as it survived in our multivariate model. It was not explained by insight as some suggested, thus the mechanism at stake remains to be explained. Conclusion The pathways to subjective QoL in schizophrenia are complex and the determinants largely influence each other. Longitudinal studies are warranted to confirm these cross-sectional findings.
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Dates et versions

hal-03338446 , version 1 (08-09-2021)

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Mickael Ehrminger, Paul Roux, Mathieu Urbach, Myrtille André, Bruno Aouizerate, et al.. The puzzle of quality of life in schizophrenia: putting the pieces together with the FACE-SZ cohort. Psychological Medicine, 2020, pp.1-8. ⟨10.1017/S0033291720003311⟩. ⟨hal-03338446⟩
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