Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-30T04:14:52.963Z Has data issue: false hasContentIssue false
  • English
  • Français

The puzzle of quality of life in schizophrenia: putting the pieces together with the FACE-SZ cohort

Published online by Cambridge University Press:  23 September 2020

Mickael Ehrminger Open the ORCID record for Mickael Ehrminger [Opens in a new window] ,
Paul Roux ,
Mathieu Urbach ,
Myrtille André ,
Bruno Aouizerate ,
Fabrice Berna ,
Anne-Lise Bohec ,
Delphine Capdevielle ,
Isabelle Chéreau  and
Julie Clauss
...Show all authors
Mickael Ehrminger*
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Paul Roux
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Mathieu Urbach
Affiliation:
University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France Fondation Fondamental, Créteil, France
Myrtille André
Affiliation:
Fondation Fondamental, Créteil, France University Department of Adult Psychiatry, La Colombière Hospital, Montpellier, France
Bruno Aouizerate
Affiliation:
Fondation Fondamental, Créteil, France Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), France
Fabrice Berna
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospitals of Strasbourg, Strasbourg, France University of Strasbourg, INSERM U1114, Strasbourg, France
Anne-Lise Bohec
Affiliation:
Fondation Fondamental, Créteil, France University Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Center for Research in Neuroscience, PSYR2 Team, Le Vinatier Hospital, Bron, France
Delphine Capdevielle
Affiliation:
Fondation Fondamental, Créteil, France University of Montpellier, PSNREC, Neuropsychiatry: Epidemiological and Clinical Research, INSERM, Montpellier, France
Isabelle Chéreau
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Julie Clauss
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospitals of Strasbourg, Strasbourg, France University of Strasbourg, INSERM U1114, Strasbourg, France
Caroline Dubertret
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, Louis Mourier Hospital, Colombes, France University Paris Descartes, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France University Paris Diderot, School of Medicine, Sorbonne Paris Cité, Paris, France
Julien Dubreucq
Affiliation:
Fondation Fondamental, Créteil, France Psychosocial Rehabilitation Reference Centre, Alpes-Isère Hospital, Grenoble, France
Guillaume Fond
Affiliation:
Fondation Fondamental, Créteil, France Department of Public Health, La Conception University Hospital, Marseille, France School of medicine, University of Aix-Marseille, EA 3279, Marseille, France
Roxana-Mihaela Honciuc
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Christophe Lançon
Affiliation:
Fondation Fondamental, Créteil, France School of medicine, University of Aix-Marseille, EA 3279, Marseille, France Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
Hakim Laouamri
Affiliation:
Fondation Fondamental, Créteil, France
Sylvain Leigner
Affiliation:
Fondation Fondamental, Créteil, France Psychosocial Rehabilitation Reference Centre, Alpes-Isère Hospital, Grenoble, France
Jasmina Mallet
Affiliation:
Fondation Fondamental, Créteil, France Department of Psychiatry, Louis Mourier Hospital, Colombes, France University Paris Descartes, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France University Paris Diderot, School of Medicine, Sorbonne Paris Cité, Paris, France
David Misdrahi
Affiliation:
Fondation Fondamental, Créteil, France Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
Baptiste Pignon
Affiliation:
Fondation Fondamental, Créteil, France INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Mondor University Hospital, Créteil, France School of medicine, University of Paris-Est, Créteil, France
Romain Rey
Affiliation:
Fondation Fondamental, Créteil, France University Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Center for Research in Neuroscience, PSYR2 Team, Le Vinatier Hospital, Bron, France
Franck Schürhoff
Affiliation:
Fondation Fondamental, Créteil, France INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Mondor University Hospital, Créteil, France School of medicine, University of Paris-Est, Créteil, France
Christine Passerieux
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Eric Brunet-Gouet
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France University Department of Adult Psychiatry and Addictology, Versailles Hospital, Le Chesnay, France University Paris Saclay, ‘PsyDev’ Team, CESP, Inserm, Villejuif, France Fondation Fondamental, Créteil, France
Members of the FACE-SCZ Group
Affiliation:
University Paris Saclay – UVSQ, Health Sciences department, EA 4047 HANDIReSP, Laboratory for clinical and public health research on psychological, cognitive and motor disability, Versailles, France
*
Author for correspondence: Mickael Ehrminger, E-mail: mickael.ehrminger@uvsq.fr
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The determinants of quality of life (QoL) in schizophrenia are largely debated, mainly due to methodological discrepancies and divergence about the concepts concerned. As most studies have investigated bi- or tri-variate models, a multivariate model accounting for simultaneous potential mediations is necessary to have a comprehensive view of the determinants of QOL. We sought to estimate the associations between cognitive reserve, cognition, functioning, insight, depression, schizophrenic symptoms, and QoL in schizophrenia and their potential mediation relationships.

Methods

We used structural equation modeling with mediation analyses to test a model based on existing literature in a sample of 776 patients with schizophrenia from the FondaMental Foundation FACE-SZ cohort.

Results

Our model showed a good fit to the data. We found better functioning to be positively associated with a better QoL, whereas better cognition, better insight, higher levels of depression, and schizophrenic symptoms were associated with a lower QoL in our sample. Cognitive reserve is not directly linked to QoL, but indirectly in a negative manner via cognition. We confirm the negative relationship between cognition and subjective QoL which was previously evidenced by other studies; moreover, this relationship seems to be robust as it survived in our multivariate model. It was not explained by insight as some suggested, thus the mechanism at stake remains to be explained.

Conclusion

The pathways to subjective QoL in schizophrenia are complex and the determinants largely influence each other. Longitudinal studies are warranted to confirm these cross-sectional findings.

Keywords

Cognitionmediation analysesquality of lifestructural equation modeling
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 8 , June 2022 , pp. 1501 - 1508
Check for updates
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Members of the FACE-SCZ Group

References

Aaronson, N. K., Acquadro, C., Alonso, J., Apolone, G., Bucquet, D., Bullinger, M., … Keller, S. (1992). International Quality of Life Assessment (IQOLA) Project. Quality of Life Research, 1, 349–351.CrossRefGoogle ScholarPubMed
Addington, D., Addington, J., Maticka-Tyndale, E., & Joyce, J. (1992). Reliability and validity of a depression rating scale for schizophrenics. Schizophrenia Research, 6, 201–208.Google ScholarPubMed
Aleman, A., Agrawal, N., Morgan, K. D., & David, A. S. (2006). Insight in psychosis and neuropsychological function: Meta-analysis. The British Journal of Psychiatry: The Journal of Mental Science, 189, 204–212.CrossRefGoogle ScholarPubMed
Alptekin, K., Akvardar, Y., Kivircik Akdede, B. B., Dumlu, K., Işik, D., Pirinçci, F., … Kitiş, A. (2005). Is quality of life associated with cognitive impairment in schizophrenia? Progress in Neuro-Psychopharmacology & Biological Psychiatry, 29, 239–244.CrossRefGoogle Scholar
Alwin, D. F., & Hauser, R. M. (1975). The decomposition of effects in path analysis. American Sociological Review, 40, 37.CrossRefGoogle Scholar
Amoretti, S., Cabrera, B., Torrent, C., Mezquida, G., Lobo, A., González-Pinto, A., … PEPsGroup (2018) Cognitive reserve as an outcome predictor: First-episode affective versus non-affective psychosis. Acta Psychiatrica Scandinavica 138, 441–455.CrossRefGoogle ScholarPubMed
Anaya, C., Torrent, C., Caballero, F. F., Vieta, E., Bonnin, C. D. M., Ayuso-Mateos, J. L., & CIBERSAM Functional Remediation Group (2016) Cognitive reserve in bipolar disorder: Relation to cognition, psychosocial functioning and quality of life. Acta Psychiatrica Scandinavica 133, 386–398.CrossRefGoogle ScholarPubMed
Awad, A. G., & Voruganti, L. N. P. (2012). Measuring quality of life in patients with schizophrenia: An update. PharmacoEconomics, 30, 183–195.CrossRefGoogle ScholarPubMed
Baddeley, A. D., Emslie, H., & Nimmo-Smith, I. (2006) Doors and people: A test of visual and verbal recall and recognition. London: Harcourt Assessment.Google Scholar
Birchwood, M., Smith, J., Drury, V., Healy, J., Macmillan, F., & Slade, M. (1994). A self-report insight scale for psychosis: Reliability, validity and sensitivity to change. Acta Psychiatrica Scandinavica, 89, 62–67.CrossRefGoogle ScholarPubMed
Bowie, C. R., Twamley, E. W., Anderson, H., Halpern, B., Patterson, T. L., & Harvey, P. D. (2007). Self-assessment of functional status in schizophrenia. Journal of Psychiatric Research, 41, 1012–1018.CrossRefGoogle Scholar
Boyer, L., Millier, A., Perthame, E., Aballea, S., Auquier, P., & Toumi, M. (2013). Quality of life is predictive of relapse in schizophrenia. BMC Psychiatry, 13, 15.CrossRefGoogle Scholar
Boyer, L., Simeoni, M. C., Loundou, A., D'Amato, T., Reine, G., Lancon, C., & Auquier, P. (2010). The development of the S-QoL 18: A shortened quality of life questionnaire for patients with schizophrenia. Schizophrenia Research, 121, 241–250.Google ScholarPubMed
Brissos, S., Dias, V. V., Balanzá-Martinez, V., Carita, A. I., & Figueira, M. L. (2011). Symptomatic remission in schizophrenia patients: Relationship with social functioning, quality of life, and neurocognitive performance. Schizophrenia Research, 129, 133–136.CrossRefGoogle ScholarPubMed
Brissos, S., Dias, V. V., Carita, A. I., & Martinez-Arán, A. (2008). Quality of life in bipolar type I disorder and schizophrenia in remission: Clinical and neurocognitive correlates. Psychiatry Research, 160, 55–62.CrossRefGoogle ScholarPubMed
Calman, K. C. (1984). Quality of life in cancer patients – an hypothesis. Journal of Medical Ethics, 10, 124–127.CrossRefGoogle ScholarPubMed
Cavelti, M., Kvrgic, S., Beck, E.-M., Rüsch, N., & Vauth, R. (2012). Self-stigma and its relationship with insight, demoralization, and clinical outcome among people with schizophrenia spectrum disorders. Comprehensive Psychiatry, 53, 468–479.CrossRefGoogle ScholarPubMed
Chino, B., Nemoto, T., Fujii, C., & Mizuno, M. (2009). Subjective assessments of the quality of life, well-being and self-efficacy in patients with schizophrenia. Psychiatry and Clinical Neurosciences, 63, 521–528.CrossRefGoogle ScholarPubMed
Conners, C. K., & Staff, M. (2000). Conners’ continuous performance test II. North Tonawanda, NY: Multi-Health Systems Inc.Google Scholar
Cotton, S. M., Gleeson, J. F. M., Alvarez-Jimenez, M., & McGorry, P. D. (2010). Quality of life in patients who have remitted from their first episode of psychosis. Schizophrenia Research, 121, 259–265.CrossRefGoogle ScholarPubMed
Delis, D. C. (2000). CVLT-II: California verbal learning test: Adult version. San Antonio, Texas: Psychological Corporation.Google Scholar
DeRosse, P., Nitzburg, G. C., Blair, M., & Malhotra, A. K. (2018). Dimensional symptom severity and global cognitive function predict subjective quality of life in patients with schizophrenia and healthy adults. Schizophrenia Research, 195, 385–390.CrossRefGoogle ScholarPubMed
Eack, S. M., & Newhill, C. E. (2007). Psychiatric symptoms and quality of life in schizophrenia: A meta-analysis. Schizophrenia Bulletin, 33, 1225–1237.CrossRefGoogle ScholarPubMed
Ehrminger, M., Urbach, M., Passerieux, C., Aouizerate, B., Berna, F., Bohec, A.-L., … Roux, P. (2019). Modeling the longitudinal effects of insight on depression, quality of life and suicidality in schizophrenia spectrum disorders: Results from the FACE-SZ cohort. Journal of Clinical Medicine, 8(8), 1196.CrossRefGoogle ScholarPubMed
Elkana, O., Soffer, S., Eisikovits, O. R., Oren, N., Bezalel, V., & Ash, E. L. (2019). WAIS information subtest as an indicator of crystallized cognitive abilities and brain reserve among highly educated older adults: A three-year longitudinal study. Applied Neuropsychology. Adult, 1–7. Advanced online publication. doi:10.1080/23279095.2019.1575219.Google ScholarPubMed
Enders, C. K., & Bandalos, D. L. (2001). The performance of the full information maximum likelihood estimator in multiple regression models with missing data. Educational and Psychological Measurement, 61, 713–740.CrossRefGoogle Scholar
Fairchild, A. J., & McDaniel, H. L. (2017). Best (but oft-forgotten) practices: Mediation analysis. The American Journal of Clinical Nutrition, 105, 1259–1271.Google ScholarPubMed
Fontanil-Gómez, Y., Alcedo Rodríguez, M. A., & Gutiérrez López, M. I. (2017). Personal and macro-systemic factors as predictors of quality of life in chronic schizophrenia. Psicothema, 29, 160–165.Google ScholarPubMed
Galderisi, S., Rossi, A., Rocca, P., Bertolino, A., Mucci, A., Bucci, P., … Maj, M. (2016). Pathways to functional outcome in subjects with schizophrenia living in the community and their unaffected first-degree relatives. Schizophrenia Research, 175, 154–160.CrossRefGoogle ScholarPubMed
Gerretsen, P., Voineskos, A. N., Graff-Guerrero, A., Menon, M., Pollock, B. G., Mamo, D. C., … Rajji, T. K. (2017). Insight into illness and cognition in schizophrenia in earlier and later life. The Journal of Clinical Psychiatry, 78, e390–e397.CrossRefGoogle ScholarPubMed
Gold, J. M., & Harvey, P. D. (1993). Cognitive deficits in schizophrenia. The Psychiatric Clinics of North America, 16, 295–312.CrossRefGoogle Scholar
Hasson-Ohayon, I., Kravetz, S., Meir, T., & Rozencwaig, S. (2009). Insight into severe mental illness, hope, and quality of life of persons with schizophrenia and schizoaffective disorders. Psychiatry Research, 167, 231–238.CrossRefGoogle ScholarPubMed
Heinrichs, R. W., & Zakzanis, K. K. (1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12, 426.CrossRefGoogle Scholar
Herman, M. (2004). Neurocognitive functioning and quality of life among dually diagnosed and non-substance abusing schizophrenia inpatients. International Journal of Mental Health Nursing, 13, 282–291.CrossRefGoogle ScholarPubMed
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55.CrossRefGoogle Scholar
Jones, S. H., Thornicroft, G., Coffey, M., & Dunn, G. (1995). A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). The British Journal of Psychiatry: The Journal of Mental Science, 166, 654–659.CrossRefGoogle Scholar
Jovanovski, D., Zakzanis, K. K., Atia, M., Campbell, Z., & Young, D. A. (2007). A comparison between a researcher-rated and a self-report method of insight assessment in chronic schizophrenia revisited: A replication study using the SUMD and SAIQ. The Journal of Nervous and Mental Disease, 195, 165–169.CrossRefGoogle Scholar
Kay, S. R., Fiszbein, A., & Opfer, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261.CrossRefGoogle Scholar
Kurtz, M. M., Gopal, S., John, S., & Thara, R. (2019). Objective psychosocial function vs. subjective quality-of-life in schizophrenia within 5-years after diagnosis: A study from southern India. Psychiatry Research, 272, 419–424.CrossRefGoogle ScholarPubMed
Kurtz, M. M., & Tolman, A. (2011). Neurocognition, insight into illness and subjective quality-of-life in schizophrenia: What is their relationship? Schizophrenia Research, 127, 157–162.CrossRefGoogle ScholarPubMed
Lemmens, L. H. J. M., Müller, V. N. L. S., Arntz, A., & Huibers, M. J. H. (2016). Mechanisms of change in psychotherapy for depression: An empirical update and evaluation of research aimed at identifying psychological mediators. Clinical Psychology Review, 50, 95–107.CrossRefGoogle ScholarPubMed
Lezak, M. D. (2004). Neuropsychological assessment. New York, USA: Oxford University Press.Google Scholar
Lien, Y.-J., Chang, H.-A., Kao, Y.-C., Tzeng, N.-S., Lu, C.-W., & Loh, C.-H. (2018). The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 268, 27–38.CrossRefGoogle ScholarPubMed
Lysaker, P. H., Roe, D., & Yanos, P. T. (2007). Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophrenia Bulletin, 33, 192–199.CrossRefGoogle ScholarPubMed
Mackinnon, A., & Mulligan, R. (2005). The estimation of premorbid intelligence levels in French speakers. L'Encephale, 31, 31–43.CrossRefGoogle ScholarPubMed
Margariti, M., Ploumpidis, D., Economou, M., Christodoulou, G. N., & Papadimitriou, G. N. (2015). Quality of life in schizophrenia spectrum disorders: Associations with insight and psychopathology. Psychiatry Research, 225, 695–701.CrossRefGoogle ScholarPubMed
Meesters, P. D., Comijs, H. C., de Haan, L., Smit, J. H., Eikelenboom, P., Beekman, A. T., & Stek, M. L. (2013). Subjective quality of life and its determinants in a catchment area based population of elderly schizophrenia patients. Schizophrenia Research, 147, 275–280.CrossRefGoogle Scholar
Michel, P., Baumstarck, K., Auquier, P., Amador, X., Dumas, R., Fernandez, J., … Boyer, L. (2013). Psychometric properties of the abbreviated version of the scale to assess unawareness in mental disorder in schizophrenia. BMC Psychiatry, 13, 229.CrossRefGoogle Scholar
Nair, A., Palmer, E. C., Aleman, A., & David, A. S. (2014). Relationship between cognition, clinical and cognitive insight in psychotic disorders: A review and meta-analysis. Schizophrenia Research, 152, 191–200.CrossRefGoogle ScholarPubMed
Narvaez, J. M., Twamley, E. W., McKibbin, C. L., Heaton, R. K., & Patterson, T. L. (2008). Subjective and objective quality of life in schizophrenia. Schizophrenia Research, 98, 201–208.CrossRefGoogle Scholar
Priebe, S., McCabe, R., Junghan, U., Kallert, T., Ruggeri, M., Slade, M., & Reininghaus, U. (2011). Association between symptoms and quality of life in patients with schizophrenia: A pooled analysis of changes over time. Schizophrenia Research, 133, 17–21.CrossRefGoogle ScholarPubMed
Rabin, R., & de Charro, F. (2001). EQ-5D: A measure of health status from the EuroQol Group. Annals of Medicine, 33, 337–343.CrossRefGoogle ScholarPubMed
Raffard, S., Trouillet, R., Capdevielle, D., Gely-Nargeot, M. C., Bayard, S., Laroi, F., & Boulenger, J. P. (2010). [French adaptation and validation of the scale to assess unawareness of mental disorder]. Canadian Journal of Psychiatry, 55, 523–531.CrossRefGoogle Scholar
Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.CrossRefGoogle Scholar
Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48, 1–36.CrossRefGoogle Scholar
Savilla, K., Kettler, L., & Galletly, C. (2008). Relationships between cognitive deficits, symptoms and quality of life in schizophrenia. The Australian and New Zealand Journal of Psychiatry, 42, 496–504.CrossRefGoogle Scholar
Shallice, T., & Burgess, P. W. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727–741.CrossRefGoogle ScholarPubMed
Shin, Y.-J., Joo, Y.-H., & Kim, J.-H. (2016). Self-perceived cognitive deficits and their relationship with internalized stigma and quality of life in patients with schizophrenia. Neuropsychiatric Disease and Treatment, 12, 1411–1417.Google ScholarPubMed
VanderWeele, T., & Vansteelandt, S. (2014). Mediation analysis with multiple mediators. Epidemiologic Methods, 2(1), 95–115.CrossRefGoogle ScholarPubMed
Ventura, J., Hellemann, G. S., Thames, A. D., Koellner, V., & Nuechterlein, K. H. (2009). Symptoms as mediators of the relationship between neurocognition and functional outcome in schizophrenia: A meta-analysis. Schizophrenia Research, 113, 189–199.CrossRefGoogle ScholarPubMed
Wechsler, D., Coalson, D. L., & Raiford, S. E. (2008). WAIS-IV: Wechsler adult intelligence scale. San Antonio, TX: Pearson.Google Scholar
WHOQOL Group (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41, 1403–1409.CrossRefGoogle Scholar
Woon, P. S., Chia, M. Y., Chan, W. Y., & Sim, K. (2010). Neurocognitive, clinical and functional correlates of subjective quality of life in Asian outpatients with schizophrenia. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 34, 463–468.CrossRefGoogle ScholarPubMed
Zhou, Y., Rosenheck, R., Mohamed, S., Zhang, J., Chang, Q., Ou, Y., … He, H. (2015). Insight in inpatients with schizophrenia: Relationship to symptoms and neuropsychological functioning. Schizophrenia Research, 161, 376–381.CrossRefGoogle ScholarPubMed
Supplementary material: File

Ehrminger et al. Supplementary Materials

Ehrminger et al. Supplementary Materials

Download Ehrminger et al. Supplementary Materials(File)
File 33.3 KB