Depression and functioning are important to subjective quality of life after a first episode psychosis

Erlend Strand Gardsjord; Kristin Lie Romm; Jan Ivar Røssberg; Svein Friis; Helene Eidsmo Barder; Julie Evensen; Ulrik Haahr; Wenche ten Velden Hegelstad; Inge Joa; Jan Olav Johannessen; Johannes Langeveld; Tor Ketil Larsen; Stein Opjordsmoen; Bjørn Rishovd Rund; Erik Simonsen; Per Vaglum; Ingrid Melle

doi:10.1016/j.comppsych.2018.07.014

Depression and functioning are important to subjective quality of life after a first episode psychosis

Erlend Strand Gardsjord^*, Kristin Lie Romm, Jan Ivar Røssberg, Svein Friis, Helene Eidsmo Barder, Julie Evensen, Ulrik Haahr, Wenche ten Velden Hegelstad, Inge Joa, Jan Olav Johannessen, Johannes Langeveld, Tor Ketil Larsen, Stein Opjordsmoen, Bjørn Rishovd Rund, Erik Simonsen, Per Vaglum, Ingrid Melle

^*Corresponding author for this work

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

Background: Subjective quality of life (S-QoL) is an important outcome measure in first-episode psychosis, but its associations with clinical predictors may vary across the illness course. In this study we examine the association pattern, including both direct and indirect effects, between specific predefined clinical predictors (insight, depression, positive psychotic symptoms and global functioning) and S-QoL the first ten years after a first-episode psychosis. Methods: Three hundred and one patients with a first-episode psychosis were included at first treatment, and reassessed at 3 months, 1 year, 2 years, 5 years and 10 years after inclusion. At 10-year follow-up 186 participated. S-QoL was assessed with Lehman's Quality of Life Interview. Applying a structural equation model, we investigated cross-sectional association patterns at all assessments between the predefined clinical predictors and S-QoL. Results: At baseline, only depression was significantly associated with S-QoL. At all follow-up assessments, depression and functioning showed significant associations with S-QoL. Insight was not associated with S-QoL at any of the assessments. Better insight, less depressive symptoms and less positive psychotic symptoms were all associated with higher functioning at all assessments. Functioning seems to mediate a smaller indirect inverse association between positive psychotic symptoms and S-QoL. The association pattern was stable across all follow-up assessments. Conclusions: Together with depression, functioning seems to be important for S-QoL. Functioning seems to be a mediating factor between positive symptoms and S-QoL. A focus on functional outcome continues to be important.

Original language	English
Journal	Comprehensive Psychiatry
Volume	86
Pages (from-to)	107-114
Number of pages	8
ISSN	0010-440X
DOIs	https://doi.org/10.1016/j.comppsych.2018.07.014
Publication status	Published - Oct 2018

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10.1016/j.comppsych.2018.07.014

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Gardsjord, E. S., Romm, K. L., Røssberg, J. I., Friis, S., Barder, H. E., Evensen, J., Haahr, U., ten Velden Hegelstad, W., Joa, I., Johannessen, J. O., Langeveld, J., Larsen, T. K., Opjordsmoen, S., Rund, B. R., Simonsen, E., Vaglum, P., & Melle, I. (2018). Depression and functioning are important to subjective quality of life after a first episode psychosis. Comprehensive Psychiatry, 86, 107-114. https://doi.org/10.1016/j.comppsych.2018.07.014

Gardsjord, ES, Romm, KL, Røssberg, JI, Friis, S, Barder, HE, Evensen, J, Haahr, U, ten Velden Hegelstad, W, Joa, I, Johannessen, JO, Langeveld, J, Larsen, TK, Opjordsmoen, S, Rund, BR, Simonsen, E, Vaglum, P & Melle, I 2018, 'Depression and functioning are important to subjective quality of life after a first episode psychosis', Comprehensive Psychiatry, vol. 86, pp. 107-114. https://doi.org/10.1016/j.comppsych.2018.07.014

@article{feb5cbe15f6b413fb1875e7114d249f0,

title = "Depression and functioning are important to subjective quality of life after a first episode psychosis",

abstract = "Background: Subjective quality of life (S-QoL) is an important outcome measure in first-episode psychosis, but its associations with clinical predictors may vary across the illness course. In this study we examine the association pattern, including both direct and indirect effects, between specific predefined clinical predictors (insight, depression, positive psychotic symptoms and global functioning) and S-QoL the first ten years after a first-episode psychosis. Methods: Three hundred and one patients with a first-episode psychosis were included at first treatment, and reassessed at 3 months, 1 year, 2 years, 5 years and 10 years after inclusion. At 10-year follow-up 186 participated. S-QoL was assessed with Lehman's Quality of Life Interview. Applying a structural equation model, we investigated cross-sectional association patterns at all assessments between the predefined clinical predictors and S-QoL. Results: At baseline, only depression was significantly associated with S-QoL. At all follow-up assessments, depression and functioning showed significant associations with S-QoL. Insight was not associated with S-QoL at any of the assessments. Better insight, less depressive symptoms and less positive psychotic symptoms were all associated with higher functioning at all assessments. Functioning seems to mediate a smaller indirect inverse association between positive psychotic symptoms and S-QoL. The association pattern was stable across all follow-up assessments. Conclusions: Together with depression, functioning seems to be important for S-QoL. Functioning seems to be a mediating factor between positive symptoms and S-QoL. A focus on functional outcome continues to be important.",

author = "Gardsjord, {Erlend Strand} and Romm, {Kristin Lie} and R{\o}ssberg, {Jan Ivar} and Svein Friis and Barder, {Helene Eidsmo} and Julie Evensen and Ulrik Haahr and {ten Velden Hegelstad}, Wenche and Inge Joa and Johannessen, {Jan Olav} and Johannes Langeveld and Larsen, {Tor Ketil} and Stein Opjordsmoen and Rund, {Bj{\o}rn Rishovd} and Erik Simonsen and Per Vaglum and Ingrid Melle",

year = "2018",

month = oct,

doi = "10.1016/j.comppsych.2018.07.014",

language = "English",

volume = "86",

pages = "107--114",

journal = "Comprehensive Psychiatry",

issn = "0010-440X",

publisher = "W.B.Saunders Co.",

}

TY - JOUR

T1 - Depression and functioning are important to subjective quality of life after a first episode psychosis

AU - Gardsjord, Erlend Strand

AU - Romm, Kristin Lie

AU - Røssberg, Jan Ivar

AU - Friis, Svein

AU - Barder, Helene Eidsmo

AU - Evensen, Julie

AU - Haahr, Ulrik

AU - ten Velden Hegelstad, Wenche

AU - Joa, Inge

AU - Johannessen, Jan Olav

AU - Langeveld, Johannes

AU - Larsen, Tor Ketil

AU - Opjordsmoen, Stein

AU - Rund, Bjørn Rishovd

AU - Simonsen, Erik

AU - Vaglum, Per

AU - Melle, Ingrid

PY - 2018/10

Y1 - 2018/10

N2 - Background: Subjective quality of life (S-QoL) is an important outcome measure in first-episode psychosis, but its associations with clinical predictors may vary across the illness course. In this study we examine the association pattern, including both direct and indirect effects, between specific predefined clinical predictors (insight, depression, positive psychotic symptoms and global functioning) and S-QoL the first ten years after a first-episode psychosis. Methods: Three hundred and one patients with a first-episode psychosis were included at first treatment, and reassessed at 3 months, 1 year, 2 years, 5 years and 10 years after inclusion. At 10-year follow-up 186 participated. S-QoL was assessed with Lehman's Quality of Life Interview. Applying a structural equation model, we investigated cross-sectional association patterns at all assessments between the predefined clinical predictors and S-QoL. Results: At baseline, only depression was significantly associated with S-QoL. At all follow-up assessments, depression and functioning showed significant associations with S-QoL. Insight was not associated with S-QoL at any of the assessments. Better insight, less depressive symptoms and less positive psychotic symptoms were all associated with higher functioning at all assessments. Functioning seems to mediate a smaller indirect inverse association between positive psychotic symptoms and S-QoL. The association pattern was stable across all follow-up assessments. Conclusions: Together with depression, functioning seems to be important for S-QoL. Functioning seems to be a mediating factor between positive symptoms and S-QoL. A focus on functional outcome continues to be important.

AB - Background: Subjective quality of life (S-QoL) is an important outcome measure in first-episode psychosis, but its associations with clinical predictors may vary across the illness course. In this study we examine the association pattern, including both direct and indirect effects, between specific predefined clinical predictors (insight, depression, positive psychotic symptoms and global functioning) and S-QoL the first ten years after a first-episode psychosis. Methods: Three hundred and one patients with a first-episode psychosis were included at first treatment, and reassessed at 3 months, 1 year, 2 years, 5 years and 10 years after inclusion. At 10-year follow-up 186 participated. S-QoL was assessed with Lehman's Quality of Life Interview. Applying a structural equation model, we investigated cross-sectional association patterns at all assessments between the predefined clinical predictors and S-QoL. Results: At baseline, only depression was significantly associated with S-QoL. At all follow-up assessments, depression and functioning showed significant associations with S-QoL. Insight was not associated with S-QoL at any of the assessments. Better insight, less depressive symptoms and less positive psychotic symptoms were all associated with higher functioning at all assessments. Functioning seems to mediate a smaller indirect inverse association between positive psychotic symptoms and S-QoL. The association pattern was stable across all follow-up assessments. Conclusions: Together with depression, functioning seems to be important for S-QoL. Functioning seems to be a mediating factor between positive symptoms and S-QoL. A focus on functional outcome continues to be important.

UR - http://www.scopus.com/inward/record.url?scp=85051393244&partnerID=8YFLogxK

U2 - 10.1016/j.comppsych.2018.07.014

DO - 10.1016/j.comppsych.2018.07.014

M3 - Journal article

C2 - 30114656

AN - SCOPUS:85051393244

SN - 0010-440X

VL - 86

SP - 107

EP - 114

JO - Comprehensive Psychiatry

JF - Comprehensive Psychiatry

ER -

Depression and functioning are important to subjective quality of life after a first episode psychosis

Abstract

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