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Abstract
Understanding the link between quality of life and symptoms in schizophrenia is important
in enhancing the prospect of patient recovery. Only weak associations have been found
between subjective quality of life (SQOL) and negative symptoms. However, this may
be because many existing symptom assessment scales inadequately assess the experiential
deficits of negative symptoms. This study aimed to re-evaluate these findings using
the Clinical Assessment Interview for Negative Symptoms (CAINS), which as been designed
to capture both the expressive and experiential subdomains of negative symptoms as
separate constructs. In this observational study 275 participants with at least moderate
negative symptoms were assessed three times over nine months using the CAINS, the
Positive and Negative Syndrome Scale (PANSS), and the Manchester Short Assessment
of Quality of Life (MANSA). A significant negative association between SQOL and the
CAINS experiential subscale was found in the cross-sectional analysis (adj. B=-0.28,
95% CI=-0.44 to -0.12, P=0.001), and in the change scores (adj. B=-0.13, 95% CI=-0.26
to -0.01, P=0.032). No associations between SQOL and expressive symptoms, or negative
symptoms measured using the PANSS were detected in the multivariable models. These
findings suggest that the association between negative symptoms and SQOL is related
primarily to experiential deficits, and highlights the importance of measuring the
separate subdomains of negative symptoms as distinct constructs. The findings also
highlight the impact of negative symptoms and experiential deficits in particular
on social outcomes, further emphasising the need to develop new treatments for these
symptoms.