Self-reported quality of life in a Scottish first episode psychosis cohort: associations with symptomatology and premorbid adjustment

Background
There is increased interest in quality of life (QoL) as a clinically relevant factor in adjustment to, and recovery from, first-episode psychosis (FEP). Given the subjective nature of QoL, it is proposed that this variable may be associated with compromised functioning prior to the onset of psychosis, and may also have an impact on an individual's adjustment to psychosis after treatment is initiated.

Aim
The current study aims to explore associations between subjective QoL, symptomatology, premorbid adjustment, duration of untreated psychosis (DUP) and engagement with services after onset of treatment.

Method
A cross-sectional cohort of Scottish individuals undergoing treatment for FEP were characterized in terms of psychotic symptomatology, premorbid adjustment, DUP and service engagement. Self-reported QoL was measured using the World Health Organization Quality of Life Brief Scale, allowing for the measurement of physical, psychological, social relational and environmental aspects of QoL.

Results
Higher scores for subjective QoL components were associated with better premorbid adjustment, lower positive psychotic symptoms, lower negative symptoms and less cognitive disorganization. Childhood premorbid adjustment predicted both physical and social relationship QoL.

Discussion
Subjective QoL domains differ in their associations with clinical and premorbid factors. The relationship between premorbid adjustment and QoL requires further exploration in FEP.