Quality of Life in Schizophrenia: A Meta-Analysis of Comparative Studies

Studies and findings regarding the impact of schizophrenia on quality of life (QOL) has been highly variable. This meta-analysis compared QOL between schizophrenia subjects and healthy controls with a focus on standardized measures. A systematic literature search was conducted through Pubmed, PsycINFO, EMBASE, Cochrane Library and Web of Science databases. Only studies using the World Health Organization Quality of Life (WHOQOL) or its brief version or the Short Form-36 Health Survey (SF-36) were included. Fifteen case-control studies with 2195 schizophrenia subjects and 1508 healthy controls were included in this meta-analysis. The WHOQOL/WHOQOL-BREF score was significantly lower in physical health (SMD = -1.80, 95% CI: -2.31 to -1.28, P < 0.001), psychological health (SMD = -1.28, 95% CI: -1.72 to -0.83, P < 0.001), social relationships (SMD = -1.60, 95% CI: -2.05 to -1.15, P < 0.001), and environment domains (SMD = -0.98, 95% CI: -1.38 to -0.59, P < 0.001) in schizophrenia subjects compared to controls. The SF-36 score was significantly lower in both physical (SMD = -1.09, 95% CI: -1.41 to -0.76, P < 0.001 and mental health domains (SMD = -2.08, 95% CI: -3.58 to -0.59, P = 0.006) in schizophrenia subjects than in controls. Subgroup and meta-regression analyses found that age, male gender, illness duration and income have significant moderating effects on QOL. The meta-analysis of studies with standardized measures confirmed that QOL in schizophrenia subjects is significantly lower than healthy controls. Effective interventions should be developed to improve QOL for this population.

关于精神分裂症对生活质量（QOL）影响的研究和发现差异很大。这项荟萃分析比较了精神分裂症患者和健康对照者的生活质量，重点关注标准化测量。通过PubMed、PsycINFO、Embase、Cochrane图书馆和Web of Science数据库进行了系统的文献检索。仅纳入使用世界卫生组织生活质量量表（WHOQOL）或其简版或健康调查简表 - 36（SF - 36）的研究。这项荟萃分析纳入了15项病例对照研究，涉及2195名精神分裂症患者和1508名健康对照者。与对照组相比，精神分裂症患者的WHOQOL/WHOQOL - BREF评分在身体健康（标准化均数差 = -1.80，95%置信区间：-2.31至 -1.28，P < 0.001）、心理健康（标准化均数差 = -1.28，95%置信区间：-1.72至 -0.83，P < 0.001）、社会关系（标准化均数差 = -1.60，95%置信区间：-2.05至 -1.15，P < 0.001）以及环境领域（标准化均数差 = -0.98，95%置信区间：-1.38至 -0.59，P < 0.001）方面均显著较低。精神分裂症患者的SF - 36评分在身体（标准化均数差 = -1.09，95%置信区间：-1.41至 -0.76，P < 0.001）和心理健康领域（标准化均数差 = -2.08，95%置信区间：-3.58至 -0.59，P = 0.006）均显著低于对照组。亚组和元回归分析发现，年龄、男性、病程和收入对生活质量有显著的调节作用。对采用标准化测量的研究进行的荟萃分析证实，精神分裂症患者的生活质量显著低于健康对照组。应制定有效的干预措施来提高这一人群的生活质量。