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

Published online by Cambridge University Press:  23 September 2020

Mickael Ehrminger*
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Paul Roux
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Mathieu Urbach
Affiliation:
University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France Fondation Fondamental, Créteil, France
Myrtille André
Affiliation:
Fondation Fondamental, Créteil, France University Department of Adult Psychiatry, La Colombière Hospital, Montpellier, France
Bruno Aouizerate
Affiliation:
Fondation Fondamental, Créteil, France Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), France
Fabrice Berna
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospitals of Strasbourg, Strasbourg, France University of Strasbourg, INSERM U1114, Strasbourg, France
Anne-Lise Bohec
Affiliation:
Fondation Fondamental, Créteil, France University Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Center for Research in Neuroscience, PSYR2 Team, Le Vinatier Hospital, Bron, France
Delphine Capdevielle
Affiliation:
Fondation Fondamental, Créteil, France University of Montpellier, PSNREC, Neuropsychiatry: Epidemiological and Clinical Research, INSERM, Montpellier, France
Isabelle Chéreau
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Julie Clauss
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospitals of Strasbourg, Strasbourg, France University of Strasbourg, INSERM U1114, Strasbourg, France
Caroline Dubertret
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, Louis Mourier Hospital, Colombes, France University Paris Descartes, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France University Paris Diderot, School of Medicine, Sorbonne Paris Cité, Paris, France
Julien Dubreucq
Affiliation:
Fondation Fondamental, Créteil, France Psychosocial Rehabilitation Reference Centre, Alpes-Isère Hospital, Grenoble, France
Guillaume Fond
Affiliation:
Fondation Fondamental, Créteil, France Department of Public Health, La Conception University Hospital, Marseille, France School of medicine, University of Aix-Marseille, EA 3279, Marseille, France
Roxana-Mihaela Honciuc
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Christophe Lançon
Affiliation:
Fondation Fondamental, Créteil, France School of medicine, University of Aix-Marseille, EA 3279, Marseille, France Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
Hakim Laouamri
Affiliation:
Fondation Fondamental, Créteil, France
Sylvain Leigner
Affiliation:
Fondation Fondamental, Créteil, France Psychosocial Rehabilitation Reference Centre, Alpes-Isère Hospital, Grenoble, France
Jasmina Mallet
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, Louis Mourier Hospital, Colombes, France University Paris Descartes, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France University Paris Diderot, School of Medicine, Sorbonne Paris Cité, Paris, France
David Misdrahi
Affiliation:
Fondation Fondamental, Créteil, France Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
Baptiste Pignon
Affiliation:
Fondation Fondamental, Créteil, France INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Mondor University Hospital, Créteil, France School of medicine, University of Paris-Est, Créteil, France
Romain Rey
Affiliation:
Fondation Fondamental, Créteil, France University Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Center for Research in Neuroscience, PSYR2 Team, Le Vinatier Hospital, Bron, France
Franck Schürhoff
Affiliation:
Fondation Fondamental, Créteil, France INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Mondor University Hospital, Créteil, France School of medicine, University of Paris-Est, Créteil, France
Christine Passerieux
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Eric Brunet-Gouet
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Members of the FACE-SCZ Group
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France
*
Author for correspondence: Mickael Ehrminger, E-mail: mickael.ehrminger@uvsq.fr

Abstract

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.

Type
Original Article
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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Footnotes

*

Members of the FACE-SCZ Group

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