This article has been cited by other articles in PMC. Clinicians are often reticent to treat ADHD in patients with psychosis, fearing that psychostimulants will worsen psychotic symptoms.
Advanced Search Abstract Quality of life QoL has been recognized as an important outcome of schizophrenia treatment, yet the determinants of QoL for individuals with schizophrenia are not well known.
Research has consistently found psychiatric symptoms to be negatively related to QoL, however, findings concerning the strength of these relationships have been mixed, making it difficult to determine the degree to which such symptoms are related to poor QoL.
This research presents a systematic meta-analysis of studies examining the relationship between psychiatric symptoms and QoL in schizophrenia, in an effort to elucidate the determinants of QoL for this population. Weighted effect size analyses revealed small relationships between psychiatric symptoms and QoL, with general psychopathology showing the strongest negative associations across all QoL indicators.
Moderator analyses indicated that variation in effect sizes could be accounted for by differing operationalizations of QoL, study design, sample, and participant treatment setting. In particular, positive and negative symptoms were more strongly related to poor QoL among studies of schizophrenia outpatients, whereas general psychopathology showed a consistent negative relationship with QoL across all study samples and treatment settings.
Implications for future research and treatment development are discussed. Unfortunately, the factors that influence QoL in schizophrenia are not well known.
One factor consistently shown to be negatively associated with QoL is psychiatric symptoms. Furthermore, the strength of these associations has also been difficult to discern, with some studies finding small to moderate relationships between psychiatric symptoms and QoL 67 and others presenting findings that suggest that certain aspects of these concepts may be indistinguishable.
For example, if indicators of QoL share only a modest amount variance with psychiatric symptoms, such findings would suggest that measures of QoL not only possess some discriminant validity but would also point to the importance of looking beyond symptom-reduction strategies for improving QoL in schizophrenia.
Additionally, because certain psychiatric symptoms likely share more variance with QoL than other symptoms clarifying the differential relationships among various patterns of symptomatology and QoL could point to important constraints regarding the use of QoL assessments in schizophrenia research, as well as suggest fruitful directions toward improving QoL for individuals living with the illness.
While these issues have been the focus of much research over the past several decades 510 and are of particular importance if measures of QoL are to be the benchmarks for novel treatments aimed at improving functional outcomes in schizophrenia, to date, findings across studies have been mixed.
The research reported here attempts to account for this variation and provide clarification about the nature of the relationship between psychiatric symptoms and QoL in schizophrenia, through the systematic use of meta-analytic techniques, in an effort to identify the symptomatic determinants of QoL in schizophrenia and the utility of the concept in schizophrenia research.
The QoL literature in addressing schizophrenia has been particularly difficult to summarize because of the disparities in the definitions researchers have used to operationalize the concept.
Both sides of this argument are equally compelling. Proponents of subjective indicators of QoL point to the importance of understanding and acknowledging the unique perspectives individuals with schizophrenia have about their lives, 19 and proponents of objective indicators emphasize the need for measures uncontaminated by mood states and cognitive disturbances.
Some investigators define QoL as a global evaluation of one's total life experiences, 20 others focus more narrowly on the absence of disease and health-related symptoms, 21 and still others focus on discrete indicators of social and material wellbeing.
For example, Gladis et al 10 identify 2 predominant models of QoL that have guided, either implicitly or explicitly, research in this area. The second model focuses on health eg, functional impairment and social and material wellbeing eg, number of close friends, adequacy of financial resources and is often measured by objective evaluations.
Lehman's 4 review of the measurement literature suggests a similar multidimensional model of QoL incorporating an overall sense of well-being, functional status, and access to resources and opportunities. Other reviews of the literature, including some of the early sociological models, conceptualize QoL in a similar fashion.
Although comprehensive factor-analytic investigations have yet to be conducted to empirically establish these 4 dimensions of QoL, each dimension is supported by a considerable body of literature, both in psychiatry and other disciplines, and unique measurement techniques.Disclaimer: The following symptoms overlap with many other diseases such as bipolar disorder, major depression, the various kinds of personality disorders (specifically paranoid and schizotypal personality disorders), and other problems such as brain tumors and temporal lobe epilepsy.
There is no "typical" case of schizophrenia.
Cite this article: Michael T. Compton. Age at Onset and Mode of Onset of Psychosis: Two Prognostic Indicators in the Early Course of Schizophrenia - Medscape - Jul 15, Mar 16, · The authors estimated that among offspring of women with both prenatal pyelonephritis and a positive family history of psychotic disorders, % of schizophrenia cases resulted from the synergistic action of the 2 risk factors.
Commonalities Between Attention-Deficit Hyperactivity Disorder and Psychotic Disorders. the possibility that these were comorbid cases with symptoms of ADHD preceding the onset of schizophrenia cannot be excluded. A history of ADHD symptoms in schizophrenia is indicative of poorer psychiatric outcome.
Schizophrenia may be the most severe of the mental illnesses. 1 Symptoms of schizophrenia are traditionally divided Nutritional deficiency in pregnancy may play a role in the origin of some cases of schizophrenia. 39 The risk for schizophrenia increased 2-fold in Genome scan meta-analysis of schizophrenia and bipolar disorder.
The prevalence of schizophrenia is between % and % in the U.S. population. 10 Moreover, a claims analysis has estimated that the annual prevalence of diagnosed schizophrenia in the U.S. is per 1, lives. 11 The prevalence of the disorder seems to be equal in males and females, although the onset of symptoms occurs at an .