A structural equation modelling approach to explore the determinants of ă quality of life in schizophrenia

Objective: This study aimed to analyse the relationships among psychotic ă symptoms, depression, neurocognition and functioning as determinants of ă quality of life (QoL) in patients with schizophrenia. ă Methods: In this cross-sectional study, we evaluated QoL with the ă Schizophrenia Quality of Life 18-item scale (S-QoL 18), neurocognition ă with multiple tests exploring memory, attention and executive functions, ă the severity of psychotic symptoms with the Positive and Negative ă Syndrome Scale (PANSS), depression with the Calgary Depression Scale for ă Schizophrenia (CDSS) and functioning using the Functional Remission Of ă General Schizophrenia (FROGS) scale. We used Structural Equation ă Modelling (SEM) to describe the relationships among the severity of ă psychotic symptoms, depression, neurocognition, functioning and QoL. ă Results: Two hundred and seventy-one outpatients with schizophrenia ă participated in our study. SEM showed good fit with chi(2)/df = 1.97, ă root mean square error of approximation = 0.06, comparative fit index = ă 0.93 and standardized root mean square residuals = 0.05. This model ă revealed that depression was the most important feature associated with ă QoL, mainly for the self-esteem, autonomy and resilience dimensions ă (direct path coefficient = -0.46). The direct path between functioning ă and QoL was also significant (path coefficient = 0.26). The severity of ă psychotic symptoms and neurocognitive impairment were weakly and ă indirectly associated with QoL via functioning (path coefficients = ă -0.18 and 0.04, respectively). ă Conclusions: This study contributes to a better understanding of the ă determinants of QoL in schizophrenia. Our findings should be considered ă in developing effective strategies for improving QoL among this ă population. (C) 2016 Elsevier B.V. All rights reserved.