Skip to main content
Top
Gepubliceerd in: Quality of Life Research 10/2015

09-04-2015

How to interpret multidimensional quality of life questionnaires for patients with schizophrenia?

Auteurs: Pierre Michel, Pascal Auquier, Karine Baumstarck, Anderson Loundou, Badih Ghattas, Christophe Lançon, Laurent Boyer

Gepubliceerd in: Quality of Life Research | Uitgave 10/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

The classification of patients into distinct categories of quality of life (QoL) levels may be useful for clinicians to interpret QoL scores from multidimensional questionnaires. The aim of this study had been to define clusters of QoL levels from a specific multidimensional questionnaire (SQoL18) for patients with schizophrenia by using a new method of interpretable clustering and to test its validity regarding socio-demographic, clinical, and QoL information.

Methods

In this multicentre cross-sectional study, patients with schizophrenia have been classified using a hierarchical top-down method called clustering using unsupervised binary trees (CUBT). A three-group structure has been employed to define QoL levels as “high”, “moderate”, or “low”. Socio-demographic, clinical, and QoL data have been compared between the three clusters to ensure their clinical relevance.

Results

A total of 514 patients have been analysed: 78 are classified as “low”, 265 as “moderate”, and 171 as “high”. The clustering shows satisfactory statistical properties, including reproducibility (using bootstrap analysis) and discriminancy (using factor analysis). The three clusters consistently differentiate patients. As expected, individuals in the “high” QoL level cluster report the lowest scores on the Positive and Negative Syndrome Scale (p = 0.01) and the Calgary Depression Scale (p < 0.01), and the highest scores on the Global Assessment of Functioning (p < 0.03), the SF36 (p < 0.01), the EuroQol (p < 0.01), and the Quality of Life Inventory (p < 0.01).

Conclusion

Given the ease with which this method can be applied, classification using CUBT may be useful for facilitating the interpretation of QoL scores in clinical practice.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Literatuur
1.
go back to reference Awad, A. G., & Voruganti, L. N. (2012). Measuring quality of life in patients with schizophrenia: An update. Pharmacoeconomics, 30(3), 183–195.CrossRefPubMed Awad, A. G., & Voruganti, L. N. (2012). Measuring quality of life in patients with schizophrenia: An update. Pharmacoeconomics, 30(3), 183–195.CrossRefPubMed
2.
go back to reference Bobes, J., Garcia-Portilla, P., Saiz, P. A., Bascaran, T., & Bousono, M. (2005). Quality of life measures in schizophrenia. European Psychiatry, 20(Suppl 3), S313–S317.CrossRefPubMed Bobes, J., Garcia-Portilla, P., Saiz, P. A., Bascaran, T., & Bousono, M. (2005). Quality of life measures in schizophrenia. European Psychiatry, 20(Suppl 3), S313–S317.CrossRefPubMed
3.
go back to reference Cramer, J. A., Rosenheck, R., Xu, W., Thomas, J., Henderson, W., & Charney, D. S. (2000). Quality of life in schizophrenia: A comparison of instruments. Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia. Schizophrenia Bulletin, 26(3), 659–666.CrossRefPubMed Cramer, J. A., Rosenheck, R., Xu, W., Thomas, J., Henderson, W., & Charney, D. S. (2000). Quality of life in schizophrenia: A comparison of instruments. Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia. Schizophrenia Bulletin, 26(3), 659–666.CrossRefPubMed
4.
go back to reference Hayhurst, K. P., Drake, R. J., Massie, J. A., Dunn, G., Barnes, T. R., Jones, P. B., & Lewis, S. W. (2013). Improved quality of life over one year is associated with improved adherence in patients with schizophrenia. European Psychiatry, 29(3), 191–196.CrossRefPubMed Hayhurst, K. P., Drake, R. J., Massie, J. A., Dunn, G., Barnes, T. R., Jones, P. B., & Lewis, S. W. (2013). Improved quality of life over one year is associated with improved adherence in patients with schizophrenia. European Psychiatry, 29(3), 191–196.CrossRefPubMed
5.
go back to reference Boyer, L., Lancon, C., Baumstarck, K., Parola, N., Berbis, J., & Auquier, P. (2013). Evaluating the impact of a quality of life assessment with feedback to clinicians in patients with schizophrenia: Randomised controlled trial. British Journal of Psychiatry, 202, 447–453.CrossRefPubMed Boyer, L., Lancon, C., Baumstarck, K., Parola, N., Berbis, J., & Auquier, P. (2013). Evaluating the impact of a quality of life assessment with feedback to clinicians in patients with schizophrenia: Randomised controlled trial. British Journal of Psychiatry, 202, 447–453.CrossRefPubMed
6.
go back to reference Boyer, L., Millier, A., Perthame, E., Aballea, S., Auquier, P., & Toumi, M. (2013). Quality of life is predictive of relapse in schizophrenia. BMC Psychiatry, 13, 15.PubMedCentralCrossRefPubMed Boyer, L., Millier, A., Perthame, E., Aballea, S., Auquier, P., & Toumi, M. (2013). Quality of life is predictive of relapse in schizophrenia. BMC Psychiatry, 13, 15.PubMedCentralCrossRefPubMed
7.
go back to reference Caqueo-Urizar, A., Gutierrez-Maldonado, J., & Miranda-Castillo, C. (2009). Quality of life in caregivers of patients with schizophrenia: A literature review. Health and Quality of Life Outcomes, 7, 84.PubMedCentralCrossRefPubMed Caqueo-Urizar, A., Gutierrez-Maldonado, J., & Miranda-Castillo, C. (2009). Quality of life in caregivers of patients with schizophrenia: A literature review. Health and Quality of Life Outcomes, 7, 84.PubMedCentralCrossRefPubMed
8.
go back to reference Testart, J., Richieri, R., Caqueo-Urizar, A., Lancon, C., Auquier, P., & Boyer, L. (2013). Quality of life and other outcome measures in caregivers of patients with schizophrenia. Expert Review of Pharmacoeconomics & Outcomes Research, 13(5), 641–649.CrossRef Testart, J., Richieri, R., Caqueo-Urizar, A., Lancon, C., Auquier, P., & Boyer, L. (2013). Quality of life and other outcome measures in caregivers of patients with schizophrenia. Expert Review of Pharmacoeconomics & Outcomes Research, 13(5), 641–649.CrossRef
9.
go back to reference Halyard, M. Y., Frost, M. H., & Dueck, A. (2006). Integrating QOL assessments for clinical and research purposes. Current Problems in Cancer, 30(6), 319–330.CrossRefPubMed Halyard, M. Y., Frost, M. H., & Dueck, A. (2006). Integrating QOL assessments for clinical and research purposes. Current Problems in Cancer, 30(6), 319–330.CrossRefPubMed
10.
go back to reference Halyard, M. Y., Frost, M. H., Dueck, A., & Sloan, J. A. (2006). Is the use of QOL data really any different than other medical testing? Current Problems in Cancer, 30(6), 261–271.CrossRefPubMed Halyard, M. Y., Frost, M. H., Dueck, A., & Sloan, J. A. (2006). Is the use of QOL data really any different than other medical testing? Current Problems in Cancer, 30(6), 261–271.CrossRefPubMed
11.
go back to reference Awad, A. G. (2012). Quality-of-life assessment in schizophrenia: The unfulfilled promise. Expert Review of Pharmacoeconomics & Outcomes Research, 11(5), 491–493.CrossRef Awad, A. G. (2012). Quality-of-life assessment in schizophrenia: The unfulfilled promise. Expert Review of Pharmacoeconomics & Outcomes Research, 11(5), 491–493.CrossRef
12.
go back to reference Greenhalgh, J., Long, A. F., & Flynn, R. (2005). The use of patient reported outcome measures in routine clinical practice: Lack of impact or lack of theory? Social Science and Medicine, 60(4), 833–843.CrossRefPubMed Greenhalgh, J., Long, A. F., & Flynn, R. (2005). The use of patient reported outcome measures in routine clinical practice: Lack of impact or lack of theory? Social Science and Medicine, 60(4), 833–843.CrossRefPubMed
13.
go back to reference Boyer, L., Baumstarck, K., Boucekine, M., Blanc, J., Lancon, C., & Auquier, P. (2013). Measuring quality of life in patients with schizophrenia:an overview. Expert Review of Pharmacoeconomics & Outcomes Research, 13(3), 343–349.CrossRef Boyer, L., Baumstarck, K., Boucekine, M., Blanc, J., Lancon, C., & Auquier, P. (2013). Measuring quality of life in patients with schizophrenia:an overview. Expert Review of Pharmacoeconomics & Outcomes Research, 13(3), 343–349.CrossRef
14.
go back to reference McGorry, P. D., Nelson, B., Goldstone, S., & Yung, A. R. (2010). Clinical staging: A heuristic and practical strategy for new research and better health and social outcomes for psychotic and related mood disorders. Canadian Journal of Psychiatry, 55(8), 486–497. McGorry, P. D., Nelson, B., Goldstone, S., & Yung, A. R. (2010). Clinical staging: A heuristic and practical strategy for new research and better health and social outcomes for psychotic and related mood disorders. Canadian Journal of Psychiatry, 55(8), 486–497.
15.
go back to reference Lin, A., Reniers, R. L., & Wood, S. J. (2013). Clinical staging in severe mental disorder: Evidence from neurocognition and neuroimaging. British Journal of Psychiatry, Suppl. 54, s11–s17.CrossRef Lin, A., Reniers, R. L., & Wood, S. J. (2013). Clinical staging in severe mental disorder: Evidence from neurocognition and neuroimaging. British Journal of Psychiatry, Suppl. 54, s11–s17.CrossRef
16.
go back to reference Fraiman, F., Ghattas, G., & Svarc, M. (2013). Interpretable clustering using unsupervised binary trees. R package experimental version: CUBT for windows. CUBT for Linux. Fraiman, F., Ghattas, G., & Svarc, M. (2013). Interpretable clustering using unsupervised binary trees. R package experimental version: CUBT for windows. CUBT for Linux.
17.
go back to reference Michel, P., Baumstarck, K., Boyer, L., Fernandez, O., Flachenecker, P., Pelletier, J., Loundou, A., Ghattas, B., & Auquier, P. (2014). Defining quality of life levels to enhance clinical interpretation in multiple sclerosis: Application of a novel clustering method. Medical Care. Michel, P., Baumstarck, K., Boyer, L., Fernandez, O., Flachenecker, P., Pelletier, J., Loundou, A., Ghattas, B., & Auquier, P. (2014). Defining quality of life levels to enhance clinical interpretation in multiple sclerosis: Application of a novel clustering method. Medical Care.
18.
go back to reference Boyer, L., Simeoni, M. C., Loundou, A., D’Amato, T., Reine, G., Lancon, C., & Auquier, P. (2010). The development of the S-QoL 18: A shortened quality of life questionnaire for patients with schizophrenia. Schizophrenia Research, 121(1–3), 241–250.CrossRefPubMed Boyer, L., Simeoni, M. C., Loundou, A., D’Amato, T., Reine, G., Lancon, C., & Auquier, P. (2010). The development of the S-QoL 18: A shortened quality of life questionnaire for patients with schizophrenia. Schizophrenia Research, 121(1–3), 241–250.CrossRefPubMed
19.
go back to reference APA. (1994). DSM-IV. Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. APA. (1994). DSM-IV. Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
20.
go back to reference CNIL. (2004). Act n°78-17 of 6 January 1978 on Data Processing, Data Files and Individual Liberties (amended by the Act of 6 August 2004 relating to the protection of individuals with regard to the processing of personal data). Journal officiel de la République Française. Assemblée Nationale et Sénat. France. CNIL. (2004). Act n°78-17 of 6 January 1978 on Data Processing, Data Files and Individual Liberties (amended by the Act of 6 August 2004 relating to the protection of individuals with regard to the processing of personal data). Journal officiel de la République Française. Assemblée Nationale et Sénat. France.
21.
go back to reference WMA. (2008). Declaration of Helsinki, Ethical Principles for Medical Research Involving Human Subjects. Seoul: World Medical Association, General Assembly. WMA. (2008). Declaration of Helsinki, Ethical Principles for Medical Research Involving Human Subjects. Seoul: World Medical Association, General Assembly.
22.
go back to reference Kay, S. R., Opler, L. A., & Fiszbein, A. (1986). Significance of positive and negative syndromes in chronic schizophrenia. British Journal of Psychiatry, 149, 439–448.CrossRefPubMed Kay, S. R., Opler, L. A., & Fiszbein, A. (1986). Significance of positive and negative syndromes in chronic schizophrenia. British Journal of Psychiatry, 149, 439–448.CrossRefPubMed
23.
go back to reference Addington, D., Addington, J., & Maticka-Tyndale, E. (1993). Assessing depression in schizophrenia: The Calgary Depression Scale. British Journal of Psychiatry. Supplement, 22, 39–44. Addington, D., Addington, J., & Maticka-Tyndale, E. (1993). Assessing depression in schizophrenia: The Calgary Depression Scale. British Journal of Psychiatry. Supplement, 22, 39–44.
24.
go back to reference Endicott, R. L., Spitzer, J. L., & Fleiss, J. C. (1976). The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.CrossRefPubMed Endicott, R. L., Spitzer, J. L., & Fleiss, J. C. (1976). The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.CrossRefPubMed
25.
go back to reference Ware, J. E. J., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.CrossRefPubMed Ware, J. E. J., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.CrossRefPubMed
26.
go back to reference EuroQoL. (1990). EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy, 16(3), 199–208.CrossRef EuroQoL. (1990). EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy, 16(3), 199–208.CrossRef
27.
go back to reference Lehman, A. F. (1983). The well-being of chronic mental patients. Archives of General Psychiatry, 40(4), 369–373.CrossRefPubMed Lehman, A. F. (1983). The well-being of chronic mental patients. Archives of General Psychiatry, 40(4), 369–373.CrossRefPubMed
28.
go back to reference Lehman, A. F. (1988). A quality of life interview for the chronically mentally ill. Evaluation and program planning, 11, 51–62.CrossRef Lehman, A. F. (1988). A quality of life interview for the chronically mentally ill. Evaluation and program planning, 11, 51–62.CrossRef
29.
go back to reference Auquier, P., Simeoni, M. C., Sapin, C., Reine, G., Aghababian, V., Cramer, J., & Lancon, C. (2003). Development and validation of a patient-based health-related quality of life questionnaire in schizophrenia: The S-QoL. Schizophrenia Research, 63(1–2), 137–149.CrossRefPubMed Auquier, P., Simeoni, M. C., Sapin, C., Reine, G., Aghababian, V., Cramer, J., & Lancon, C. (2003). Development and validation of a patient-based health-related quality of life questionnaire in schizophrenia: The S-QoL. Schizophrenia Research, 63(1–2), 137–149.CrossRefPubMed
30.
go back to reference Baumstarck, K., Boyer, L., Boucekine, M., Aghababian, V., Parola, N., Lancon, C., & Auquier, P. (2013). Self-reported quality of life measure is reliable and valid in adult patients suffering from schizophrenia with executive impairment. Schizophrenia Research, 147(1), 58–67.CrossRefPubMed Baumstarck, K., Boyer, L., Boucekine, M., Aghababian, V., Parola, N., Lancon, C., & Auquier, P. (2013). Self-reported quality of life measure is reliable and valid in adult patients suffering from schizophrenia with executive impairment. Schizophrenia Research, 147(1), 58–67.CrossRefPubMed
31.
go back to reference Breiman, L., Friedman, J. H., Olshen, R. A., & Stone, C. J. (1984). Classification and regression trees. Monterey: Wadsworth Inc. Breiman, L., Friedman, J. H., Olshen, R. A., & Stone, C. J. (1984). Classification and regression trees. Monterey: Wadsworth Inc.
32.
go back to reference Luckett, T., Butow, P. N., & King, M. T. (2009). Improving patient outcomes through the routine use of patient-reported data in cancer clinics: Future directions. Psychooncology, 18(11), 1129–1138.CrossRefPubMed Luckett, T., Butow, P. N., & King, M. T. (2009). Improving patient outcomes through the routine use of patient-reported data in cancer clinics: Future directions. Psychooncology, 18(11), 1129–1138.CrossRefPubMed
33.
go back to reference Boyer, L., Richieri, R., Faget, C., Padovani, R., Vaillant, F., Mundler, O., et al. (2012). Functional involvement of superior temporal sulcus in quality of life of patients with schizophrenia. Psychiatry Research, 202(2), 155–160.CrossRefPubMed Boyer, L., Richieri, R., Faget, C., Padovani, R., Vaillant, F., Mundler, O., et al. (2012). Functional involvement of superior temporal sulcus in quality of life of patients with schizophrenia. Psychiatry Research, 202(2), 155–160.CrossRefPubMed
34.
go back to reference Cosci, F., & Fava, G. A. (2013). Staging of mental disorders: Systematic review. Psychotherapy and Psychosomatics, 82(1), 20–34.CrossRefPubMed Cosci, F., & Fava, G. A. (2013). Staging of mental disorders: Systematic review. Psychotherapy and Psychosomatics, 82(1), 20–34.CrossRefPubMed
35.
go back to reference McKenna, S. P. (1997). Measuring quality of life in schizophrenia. European Psychiatry, 12, 267–274.CrossRef McKenna, S. P. (1997). Measuring quality of life in schizophrenia. European Psychiatry, 12, 267–274.CrossRef
36.
go back to reference Ascher-Svanum, H., Novick, D., Haro, J. M., Aguado, J., & Cui, Z. (2012). Empirically driven definitions of “good,” “moderate,” and “poor” levels of functioning in the treatment of schizophrenia. Quality of Life Research, 22(8), 2085–2094.PubMedCentralCrossRefPubMed Ascher-Svanum, H., Novick, D., Haro, J. M., Aguado, J., & Cui, Z. (2012). Empirically driven definitions of “good,” “moderate,” and “poor” levels of functioning in the treatment of schizophrenia. Quality of Life Research, 22(8), 2085–2094.PubMedCentralCrossRefPubMed
37.
go back to reference Heinrichs, D. W., Hanlon, T. E., & Carpenter, W. T, Jr. (1984). The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10(3), 388–398.CrossRefPubMed Heinrichs, D. W., Hanlon, T. E., & Carpenter, W. T, Jr. (1984). The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10(3), 388–398.CrossRefPubMed
38.
go back to reference Baraldi, A. N., & Enders, C. K. (2010). An introduction to modern missing data analyses. Journal of School Psychology, 48(1), 5–37.CrossRefPubMed Baraldi, A. N., & Enders, C. K. (2010). An introduction to modern missing data analyses. Journal of School Psychology, 48(1), 5–37.CrossRefPubMed
39.
go back to reference Lipkovich, I. A., Deberdt, W., Csernansky, J. G., Buckley, P., Peuskens, J., Kollack-Walker, S., et al. (2009). Defining “good” and “poor” outcomes in patients with schizophrenia or schizoaffective disorder: A multidimensional data-driven approach. Psychiatry Research, 170(2–3), 161–167.CrossRefPubMed Lipkovich, I. A., Deberdt, W., Csernansky, J. G., Buckley, P., Peuskens, J., Kollack-Walker, S., et al. (2009). Defining “good” and “poor” outcomes in patients with schizophrenia or schizoaffective disorder: A multidimensional data-driven approach. Psychiatry Research, 170(2–3), 161–167.CrossRefPubMed
Metagegevens
Titel
How to interpret multidimensional quality of life questionnaires for patients with schizophrenia?
Auteurs
Pierre Michel
Pascal Auquier
Karine Baumstarck
Anderson Loundou
Badih Ghattas
Christophe Lançon
Laurent Boyer
Publicatiedatum
09-04-2015
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 10/2015
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-015-0982-y

Andere artikelen Uitgave 10/2015

Quality of Life Research 10/2015 Naar de uitgave