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Quality of Life Deficit Is a Core Presentation of Functional Psychoses

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Handbook of Schizophrenia Spectrum Disorders, Volume II

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Abstract

Patients with functional psychoses (FP) exhibit an exceedingly wide range of symptoms, and a broad spectrum of cognitive and functional impairments. In addition, it has become increasingly apparent that functional psychoses are, to variable degrees, accompanied by health-related quality of life (HRQL) impairments. This chapter addresses the question of whether the HRQL impairment or deficit is a syndrome in FP. The literature, as well as new and previously published findings from the Shaar Menashe Longitudinal Study of Quality of Life will be presented. I argue that a HRQL deficit is highly prevalent and fairly marked in FP patients. The HRQL impairment has been observed before individuals exhibit signs and psychotic symptoms of schizophrenia and it is relatively stable throughout the course of the illness. This syndrome appears to be relatively independent of symptomatology and neurocognitive deficits. Finally, the author suggests that impairment in general and domain-specific quality of life in particular are sufficiently reliable, stable, and specific enough syndrome to warrant inclusion in the diagnostic criteria for FP. Limitations in the current knowledge in this area are identified, and suggestions for future research are provided.

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Abbreviations

BPD:

Bipolar disorder

BSI:

Brief symptom inventory

CGI-S:

Clinical global impression severity scale

DSAS:

Distress scale for adverse symptoms

DSM-IV:

Diagnostic and statistical manual of mental disorders – 4th edition

FGAs:

First generation antipsychotic agents

FP:

Functional psychoses

GAF:

Global assessment of functioning scale

HRQL:

Health-related quality of life

MD:

Mood disorders (MDD and BPD)

MDD:

Major depression disorder

PANSS:

Positive and negative syndromes scale

Q-LES-Q:

Quality of life enjoyment and life satisfaction questionnaire

QLS:

Quality of life scale for rating the schizophrenic deficit syndrome

QOL:

Quality of life

SA:

Schizoaffective disorder

SGAs:

Second generation antipsychotics

SZ:

Schizophrenia

TBDI:

Talbieh brief distress inventory

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Acknowledgements

I devote this award to all my teachers and patients who have taught me whatever little I have understood of this vast and enigmatic field. I also place on record my profound gratitude to all my research collaborators and associates Drs. O. Rivkin, A. Gibel, E. Bistrov, H. Farkash, H. Ilan, G. Perelroyzen, Y. Ratner, E. Shinkarenko, I. Timisky, H. Farkash, A. Lisker, and M. Arbitman who have contributed immensely to the research that I have presented in this chapter. I am forever indebted to my wife Galina Ritsner, sons Edward and Yisrael for their understanding, endless patience and encouragement when it was most required. I also with to express gratitude to Ms. Rena Kurs, B.A. (Lev-hasharon Mental Health Center, Netanya, Israel) for fruitful cooperation and editorial assistance.

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  1. Department of Psychiatry, Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel

    Michael S. Ritsner

  2. Acute Department, Sha’ar Menashe Mental Health Center, Hadera, Israel

    Michael S. Ritsner

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  1. Michael S. Ritsner
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Correspondence to Michael S. Ritsner .

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  1. , Rappaport Faculty of Medicine, Technion - Israel Institute of Technolog, Haifa, Israel

    Michael Ritsner

Appendix 1: Quality of Life Enjoyment and Satisfaction Questionnaire – Abbreviated Version (Q-LES-Q-18)

Appendix 2: Distress Scale for Adverse Symptoms (DSAS)

Appendix 3: Talbieh Brief Distress Inventory (TBDI)

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Ritsner, M.S. (2011). Quality of Life Deficit Is a Core Presentation of Functional Psychoses. In: Ritsner, M. (eds) Handbook of Schizophrenia Spectrum Disorders, Volume II. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0831-0_7

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