Subjective quality of life and its predictors among people with early psychosis in central Vietnam: a short-term longitudinal study

ABSTRACT

Subjective quality of life (sQOL) has become an established outcome indicator in psychosis research, but longitudinal studies from developing countries remain scarce. This study aimed to examine sQOL, its short-term course and its predictors among people with early psychosis in central Vietnam. Community-dwelling individuals with early psychosis and their relatives were recruited via public health facilities for a naturalistic 6 month longitudinal study. The WHO Quality of Life-Bref and other standardized assessments were administered to 77 patients at baseline and 56 at follow-up. Average sQOL levels were found to be moderate across all key domains, but individuals who reported good QOL were in the minority. Negative appraisals in the environment domain, particularly in terms of money, were more common than in other QOL areas. Although level of community functioning improved significantly over the 6 month period, mean sQOL scores remained unchanged. Generalized estimating equation models revealed that more social support, being unmarried, and absence of dysphoria and negative symptoms were significantly associated with better sQOL in most domains. In summary, functional improvement may not necessarily result in enhanced sQOL for individuals with early psychosis in this setting. Local socioeconomic factors appeared to be among the most important influences on subjective wellbeing.

KEYWORDS:

• Early psychosis
• longitudinal study
• low and middle-income countries
• predictors
• subjective quality of life

Acknowledgements

We would also like to thank the study participants, as well as the leaders and staff from the following collaborating institutions: Psychiatry Department, HUMP; Hue Provincial Psychiatric Hospital; Danang Psychiatric Hospital; Psychiatry Department, Hue Central Hospital; and participating commune health centres. We express our appreciation to Prof. Assen Jablensky (UWA) for his training and support in relation to the DIP. We also acknowledge that the first author’s living expenses were supported by an Australian Postgraduate Research Award.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Mr Seiji Humphries is a mental health social worker who has worked as a research assistant on a longitudinal evaluation of a government support programme for people with severe psychiatric disability. He has also worked for a mental health NGO as its coordinator of research and evaluation activities and as a case manager for individuals with severe mental illness. This research was completed as part of his PhD programme.

Prof. Robert King is a psychologist with a particular interest in severe and chronic forms of mental illness such as schizophrenia, having published many papers and several books in this area. He has undertaken a broad range of research and coordinated a multidisciplinary postgraduate mental health programme. He has also worked continuously in private practice for more than 30 years.

Prof. Michael P Dunne is a psychologist who specialises in the field of population mental health, particularly regarding East Asian communities. He has managed a collaborative programme between Queensland University of Technology and Faculties of Public Health in Hanoi, Hue, Ho Chi Minh City and CanTho. He has strong links with a network of Vietnamese alumni throughout the country. He is currently co-director of the Institute for Community Health Research at Hue University of Medicine and Pharmacy, Hue City.

Dr Cat Huu Nguyen is a former Chair of the Department of Psychiatry at the Hue University of Medicine and Pharmacy. He has been a practising psychiatrist in Vietnam since 1979 and obtained an AFSA (Attestation de Formation Specialise Approfondie en Psychiatrie) from Rennes University, France, in 1993. His recent research interests include schizophrenia (clinical manifestations, recovery among Vietnamese patients) and psychosomatic medicine (psychotherapy, family therapy).

ORCID

Seiji Humphries http://orcid.org/0000-0003-2935-5756

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. We would like to thank Queensland University of Technology for its non-specific funding support of the study, and the Hue Institute for Community Health Research at Hue University of Medicine and Pharmacy (HUMP) and its staff for providing in-kind support.