Health-related quality of life and psychiatric comorbidity in first episode psychosis

Background: Quality of life (QOL) has been increasingly recognized as an important outcome measure in the care of patients with severe mental illnesses. This study seeks to evaluate the health-related QOL in patients with first episode psychosis and comparing those with psychiatric comorbidity to those without in an Early Psychosis Intervention Program. Methods: Overall, 131 patients with first episode psychosis were evaluated on their principal Axis I diagnosis and any other comorbid diagnosis, severity of psychopathology, insight, social/occupational functioning, and QOL, respectively. Results: Patients with psychiatric comorbidity scored lower on Positive and Negative Symptom Scale positive symptom subscale (z = -2.84, P <.01), had a greater awareness of their mental illness (z = -3.44, P <.001) and its social consequences (z = -3.24, P < 0.001), but lower ratings on the overall QOL (z = -3.06, P < 0.01) as well as in the individual domains (physical, psychological health, social relationships, environment, all P <.05) compared with patients without any psychiatric comorbidity. On multivariate analysis, being single and the presence of psychiatric comorbidity were associated with a poorer QOL in the various subdomains. Conclusions: The association of psychiatric comorbidity with poorer QOL warrants attention. The differences in the clinical correlates may provide potential targets for early identification and highlight needs that are significant to these patients with first episode psychosis and psychiatric comorbidity. (c) 2005 Elsevier Inc. All rights reserved.