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A comprehensive model of predictors of quality of life in older adults with schizophrenia: results from the CSA study

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Abstract

Background

Numerous factors are known to influence quality of life of adults with schizophrenia. However, little is known regarding the potential predictors of quality of life in the increasing population of older adults with schizophrenia. The main objective of the present study was to propose a comprehensive model of quality of life in this specific population.

Methods

Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with schizophrenia or schizoaffective disorder recruited from French community mental-health teams. We used structural equation modeling to simultaneously examine the effects of six broad groups of clinical factors previously identified as potential predictors of quality of life in this population, including (1) severity of general psychopathology, (2) severity of depression, (3) severity of cognitive impairment, (4) psychotropic medications, (5) general medical conditions and (6) sociodemographic characteristics.

Results

General psychopathology symptoms, and in particular negative and depressive symptoms, cognitive impairment, reduced overall functioning and low education were significantly and independently associated with diminished quality of life (all p < 0.05). Greater number of medical conditions and greater number of antipsychotics were also independently and negatively associated with quality of life, although these associations did not reach statistical significance in sensitivity analyses, possibly due to limited statistical power.

Conclusion

Several domains are implicated in quality of life among older adults with schizophrenia. Interventions targeting these factors may help improve importantly quality of life of this vulnerable population.

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Acknowledgements

This study was supported by a grant from the French Ministry of Health and Social Affairs (PHRC 2008-N11-01) (https://solidarites-sante.gouv.fr/). It was promoted by the University of Reims Champagne-Ardenne (https://www.univ-reims.fr/) and the University Paris-Descartes (https://www.univ-paris5.fr/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank the Clinical Research Unit of Georges Pompidou European Hospital, and in particular Pr Gilles Chatellier, Mr Yvann Frigout and Mrs Pascaline Aucouturier, and the Clinical Research Unit of Robert Debré Hospital, and in particular Mrs Sarah Rubingher, Dr Bérengère Hubsch, Dr Eric Tran, Dr Fabien Gierski and Mr David Da Rin. We warmly thank all the patients and the investigators who made this study possible.

CSA Study group collaborators (171): Adès J, Alezrah C, Amado I, Amar G, Andréi O, Arbault D, Archambault G, Aurifeuille G, Barrière S, Béra-Potelle C, Blumenstock Y, Bardou H, Bareil-Guérin M, Barrau P, Barrouillet C, Baup E, Bazin N, Beaufils B, Ben Ayed J, Benoit M, Benyacoub K, Bichet T, Blanadet F, Blanc O, Blanc-Comiti J, Boussiron D, Bouysse AM, Brochard A, Brochart O, Bucheron B, Cabot M, Chabannes JM, Charpeaud T, Clad-Mor C, Combes C, Comisu M, Cordier B, Cormier L, Costi F, Courcelles JP, Creixell M, Cuche H, Cuervo-Lombard C, Dammak A, Da Rin D, Denis JB, Denizot H, Deperthuis A, Diers E, Dirami S, Donneau D, Dreano P, Duprat E, Duthoit D, Fernandez C, Fonfrede P, Freitas N, Gasnier P, Gauillard J, Getten F, Gierski F, Godart F, Gourevitch R, Grassin Delyle A, Gremion J, Gres H, Griner V, Guerin-Langlois C, Guggiari C, Guillin O, Hadaoui H, Haffen E, Hanon C, Haouzir S, Hazif-Thomas C, Heron A, Hubsch B, Jalenques I, Januel D, Kaladjian A, Karnycheff JF, Kebir O, Krebs MO, Lajugie C, Leboyer M, Legrand P, Lejoyeux M, Lemaire V, Leroy E, Levy-Chavagnat D, Leydier A, Liling C, Llorca PM, Loeffel P, Louville P, Lucas Navarro S, Mages N, Mahi M, Maillet O, Manetti A, Martelli C, Martin P, Masson M, Maurs-Ferrer I, Mauvieux J, Mazmanian S, Mechin E, Mekaoui L, Meniai M, Metton A, Mihoubi A, Miron M, Mora G, Niro Adès V, Nubukpo P, Omnes C, Papin S, Paris P, Passerieux C, Pellerin J, Perlbarg J, Perron S, Petit A, Petitjean F, Portefaix C, Pringuey D, Radtchenko A, Rahiou H, Raucher-Chéné D, Rauzy A, Reinheimer L, Renard M, René M, Rengade CE, Reynaud P, Robin D, Rodrigues C, Rollet A, Rondepierre F, Rousselot B, Rubingher S, Saba G, Salvarelli JP, Samuelian JC, Sánchez Rico M, Scemama-Ammar C, Schuster JP, Sechter D, Segalas B, Seguret T, Seigneurie AS, Semmak A, Slama F, Taisne S, Taleb M, Terra JL, Thefenne D, Tran E, Tourtauchaux R, Vacheron MN, Vanhoucke V, Venet E, Verdoux H, Viala A, Vidon G, Vitre M, Vurpas JL, Wagermez C, Walter M, Yon L, Zendjidjian X.

Author information

Authors and Affiliations

  1. DMU Psychiatrie et Addictologie, Service de Psychiatrie et d’Addictologie de l’Adulte et du Sujet Âgé, Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Hôpital Corentin Celton, AP-HP.Centre, Université de Paris, Paris, France

    Nicolas Hoertel, Léa Rotenberg & Frédéric Limosin

  2. Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France

    Nicolas Hoertel, Caroline Dubertret & Frédéric Limosin

  3. Faculté de Médecine Paris Descartes, Université de Paris, Paris, France

    Nicolas Hoertel & Frédéric Limosin

  4. Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA

    Carlos Blanco

  5. Université de Tours, CHRU de Tours, Tours, France

    Vincent Camus

  6. Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France

    Caroline Dubertret & Véronique Charlot

  7. Faculté de médecine Paris Diderot, Université de Paris, Paris, France

    Caroline Dubertret & Véronique Charlot

  8. AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, 94000, Créteil, France

    Franck Schürhoff

  9. Inserm, U955, Team 15, 94000, Créteil, France

    Franck Schürhoff

  10. Fondation FondaMental, 94000, Créteil, France

    Franck Schürhoff

  11. Faculté de médecine, UPEC, Université Paris-Est, 94000, Créteil, France

    Franck Schürhoff

  12. Centre d’investigation Clinique-Innovation Technologique CIC-IT 1431, Inserm, CHRU Besançon, 25000, Besançon, France

    Pierre Vandel

  13. Neurosciences Intégratives et Cliniques EA 481, Université Franche-Comté, Université Bourgogne Franche-Comté, 25000, Besançon, France

    Pierre Vandel

  14. Service de Psychiatrie de l’adulte, CHRU Besançon, 25000, Besançon, France

    Pierre Vandel

  15. Centre Mémoire de Ressource et de Recherche de Franche-Comté, CHRU Besançon, 25000, Besançon, France

    Pierre Vandel

Authors
  1. Nicolas Hoertel
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  2. Léa Rotenberg
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  3. Carlos Blanco
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  4. Vincent Camus
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  5. Caroline Dubertret
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  6. Véronique Charlot
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  7. Franck Schürhoff
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  8. Pierre Vandel
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  9. Frédéric Limosin
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Consortia

CSA Study group

  • J. Adès
  • ,  C. Alezrah
  • ,  I. Amado
  • ,  G. Amar
  • ,  O. Andréi
  • ,  D. Arbault
  • ,  G. Archambault
  • ,  G. Aurifeuille
  • ,  S. Barrière
  • ,  C. Béra-Potelle
  • ,  Y. Blumenstock
  • ,  H. Bardou
  • ,  M. Bareil-Guérin
  • ,  P. Barrau
  • ,  C. Barrouillet
  • ,  E. Baup
  • ,  N. Bazin
  • ,  B. Beaufils
  • ,  J. Ben Ayed
  • ,  M. Benoit
  • ,  K. Benyacoub
  • ,  T. Bichet
  • ,  F. Blanadet
  • ,  O. Blanc
  • ,  J. Blanc-Comiti
  • ,  D. Boussiron
  • ,  A. M. Bouysse
  • ,  A. Brochard
  • ,  O. Brochart
  • ,  B. Bucheron
  • ,  M. Cabot
  • ,  J. M. Chabannes
  • ,  T. Charpeaud
  • , C. Clad-Mor
  • ,  C. Combes
  • ,  M. Comisu
  • ,  B. Cordier
  • ,  L. Cormier
  • ,  F. Costi
  • ,  J. P. Courcelles
  • ,  M. Creixell
  • ,  H. Cuche
  • , C. Cuervo-Lombard
  • ,  A. Dammak
  • , D. Da Rin
  • ,  J. B. Denis
  • ,  H. Denizot
  • ,  A. Deperthuis
  • ,  E. Diers
  • ,  S. Dirami
  • ,  D. Donneau
  • , P. Dreano
  • ,  E. Duprat
  • ,  D. Duthoit
  • ,  C. Fernandez
  • ,  P. Fonfrede
  • ,  N. Freitas
  • ,  P. Gasnier
  • ,  J. Gauillard
  • ,  F. Getten
  • ,  F. Gierski
  • ,  F. Godart
  • ,  R. Gourevitch
  • , A. Grassin Delyle
  • ,  J. Gremion
  • ,  V. Griner
  • , C. Guerin-Langlois
  • , C. Guggiari
  • ,  O. Guillin
  • ,  H. Hadaoui
  • ,  E. Haffen
  • ,  C. Hanon
  • ,  S. Haouzir
  • , C. Hazif-Thomas
  • ,  A. Heron
  • ,  B. Hubsch
  • ,  I. Jalenques
  • ,  D. Januel
  • ,  A. Kaladjian
  • ,  J. F. Karnycheff
  • ,  O. Kebir
  • ,  M. O. Krebs
  • ,  C. Lajugie
  • ,  M. Leboyer
  • ,  P. Legrand
  • ,  M. Lejoyeux
  • ,  V. Lemaire
  • ,  E. Leroy
  • ,  D. Levy-Chavagnat
  • ,  A. Leydier
  • ,  C. Liling
  • ,  P. M. Llorca
  • ,  P. Loeffel
  • ,  P. Louville
  • , S. Lucas Navarro
  • ,  N. Mages
  • ,  M. Mahi
  • ,  O. Maillet
  • ,  A. Manetti
  • ,  C. Martelli
  • ,  P. Martin
  • ,  M. Masson
  • ,  I. Maurs-Ferrer
  • ,  J. Mauvieux
  • ,  S. Mazmanian
  • ,  E. Mechin
  • ,  L. Mekaoui
  • ,  M. Meniai
  • ,  A. Metton
  • ,  A. Mihoubi
  • ,  M. Miron
  • ,  G. Mora
  • ,  V. Niro Adès
  • ,  P. Nubukpo
  • ,  C. Omnes
  • ,  S. Papin
  • ,  P. Paris
  • ,  C. Passerieux
  • ,  J. Pellerin
  • ,  J. Perlbarg
  • ,  S. Perron
  • ,  A. Petit
  • ,  F. Petitjean
  • ,  C. Portefaix
  • ,  D. Pringuey
  • ,  A. Radtchenko
  • ,  H. Rahiou
  • ,  D. Raucher-Chéné
  • ,  A. Rauzy
  • ,  L. Reinheimer
  • ,  M. Renard
  • ,  M. René
  • ,  C. E. Rengade
  • ,  P. Reynaud
  • ,  D. Robin
  • ,  C. Rodrigues
  • ,  A. Rollet
  • ,  F. Rondepierre
  • ,  B. Rousselot
  • ,  S. Rubingher
  • ,  G. Saba
  • ,  J. P. Salvarelli
  • ,  J. C. Samuelian
  • , M. Sánchez Rico
  • , C. Scemama-Ammar
  • ,  J. P. Schuster
  • ,  D. Sechter
  • ,  B. Segalas
  • ,  T. Seguret
  • ,  A. S. Seigneurie
  • ,  A. Semmak
  • ,  F. Slama
  • ,  S. Taisne
  • ,  M. Taleb
  • ,  J. L. Terra
  • ,  D. Thefenne
  • ,  E. Tran
  • ,  R. Tourtauchaux
  • ,  M.N . Vacheron
  • ,  V. Vanhoucke
  • ,  E. Venet
  • ,  H. Verdoux
  • ,  A. Viala
  • ,  G. Vidon
  • ,  M. Vitre
  • ,  J. L. Vurpas
  • ,  C. Wagermez
  • ,  M. Walter
  • ,  L. Yon
  •  &  X. Zendjidjian

Contributions

NH, LR and FL designed the study. FL obtained the funding. NH and LR undertook statistical analyses. NH and LR wrote the first draft of the manuscript. CB, VC, CD, VC, FS, PV and FL critically reviewed the manuscript. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Nicolas Hoertel.

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Conflict of interests

FL has received speaker and consulting fees from AstraZeneca, Janssen, Lundbeck, Otsuka Pharmaceuticals, Roche and Servier, outside the submitted work. VC has received travel, accommodation and congress inscription fees from AstraZeneca, Janssen, Bouchara-Recordati, Laboratoires Servier, Lundbeck SAS, Mundipharma, Otsuka Pharmaceutical France SAS, Roche SAS, outside the submitted work. Other authors report no conflicts of interest relevant to the content of this article.

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Hoertel, N., Rotenberg, L., Blanco, C. et al. A comprehensive model of predictors of quality of life in older adults with schizophrenia: results from the CSA study. Soc Psychiatry Psychiatr Epidemiol 56, 1411–1425 (2021). https://doi.org/10.1007/s00127-020-01880-2

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