Determinants of quality of life at first presentation with schizophrenia

BACKGROUND: Quality of life (QOL) has gained importance as a global measure of social and clinical outcome in schizophrenia. AIMS: To identify the clinical correlates of QOL at the time of first presentation with schizophrenia. METHOD: Over two years, consecutive first-episode psychosis patients presenting to a catchment area psychiatric service underwent validated clinical assessments of premorbid adjustment, illness duration, symptoms and QOL. RESULTS: At presentation, subjects already had a diminished QOL. Although independent of gender and age at onset of psychosis, QOL was influenced by premorbid adjustment, duration of untreated psychosis and symptoms. CONCLUSIONS: Reducing the duration of untreated psychosis may have a beneficial effect on the subsequent QOL of patients presenting with schizophrenia. First-episode patients with a protracted duration of untreated psychosis or impaired premorbid adjustment may warrant specific treatment interventions to prevent the development of secondary handicaps.