정신분열병 환자의 삶의 질과 정신병리: 주관 및 객관적 평가

Abstract

Objectives: In previous researches the measure of quality of life was assessed either by the subjective experience only or by the objective assessment only, but there have been few studies done using both of these measures and the relationship between these two sides.

The aim of this study is to examine the relationship between the subjective experience and the objective assessment of the quality of life in schizophrenic patients and to find out whether the self-rating of these patients is reliable. Also, the relationship between the assessment of the quality of life and the psychopathology of schizophrenia was investigated.

Methods: The subjects are 48 out-patients, from either Yongdong Severance Hospital or Seoul Paik Hospital, whose diagnosis were schizophrenia according to DSM-Ⅳ. The standardized Korea version of Quality of Life Scale(K-QOLS) was used for evaluating the objective assessment of quality of life, while both the Korean modification of the Scale to Measure Subjective Well-being under Neuroleptic treatment(KmSWN, 2000) and the Satisfaction of Life Scale(SOL) was used in the evaluation of subjective experience of satisfaction of life. The psychopathology of each patient was assessed by the Positive and Negative Syndrome Scale(PANSS). The patient underwent all the scales on the same day, and the relationship between each scale were analysed by the Spearman's correlation coefficient.

Results: The results came out that the total score of PANSS showed negative correlations with the total score of K-QOLS, especially the negative subscale score and the general psychopathology subscale score was correlated more significantly. The total score of KmSWN showed no correlations with neither the total score nor the positive/negative subscale score of PANSS, but the general psychopathology subscale score showed negative correlations with KmSWN significantly. The score of K-QOLS, reflecting the objective assessment, and the score of KmSWN, reflecting the subjective experience, showed positive correlations with each other. But the total score of SOL, reflecting the subjective experience also, showed no correlations with K-QOLS.

The score of KmSWN showed positive correlations with the subdomains of interpersonal relations and intrapsychic foundation of K-QOLS, but did not correlate with occuaptional role and daily acitivities. Especially the emotional regulation, the subdomain of KmSWN showed positive correlations with the subscales of K-QOLS. And the subjective and objective quality of life scale both showed negative correlations with the duration of illness and dosages of drugs.

Conclusions: These results suggested that the more severe the psychopathology, the lower the objective quality of life in out-patients with schizophrenia, and the more severe the general psychopathology, the lower the subjective quality of life. The positive relationships between the subjective measure and the objective measure in quality of life were also proved, suggesting that the self-rating of these patients is reliable. The longer the duration of illness and the higher the dosages of drugs, the lower the quality of life in patients with schizophrenia.