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Psychiatric symptoms and quality of life in older adults with schizophrenia spectrum disorder: results from a multicenter study

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Abstract

The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with schizophrenia spectrum disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with schizophrenia spectrum disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with schizophrenia spectrum disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension (β = − 0.43, p < 0.01). Negative symptom dimension had an additional negative effect on QoL beyond the effect of that factor (β = − 0.28, p < 0.01). Because psychiatric symptoms affect QoL mainly through two dimensions of psychopathology, i.e., a general psychopathology dimension and a negative symptom dimension, mechanisms underlying those dimensions should be considered as promising targets for therapeutic interventions to substantially improve quality of life of this vulnerable population.

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References

  1. Hjorthøj C, Stürup AE, McGrath JJ, Nordentoft M (2017) Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry 4(4):295–301

    PubMed  Google Scholar 

  2. Kahn RS, Sommer IE, Murray RM, Meyer-Lindenberg A, Weinberger DR, Cannon TD, O’Donovan M, Correll CU, Kane JM, van Os J, Insel TR (2015) Schizophrenia. Nat Rev Dis Primers 12(1):15067

    Google Scholar 

  3. Talaslahti T, Alanen HM, Hakko H, Isohanni M, Häkkinen U, Leinonen E (2012) Mortality and causes of death in older patients with schizophrenia. Int J Geriatr Psychiatry 27(11):1131–1137

    PubMed  Google Scholar 

  4. Tiihonen J, Lönnqvist J, Wahlbeck K, Klaukka T, Niskanen L, Tanskanen A, Haukka J (2009) 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 374(9690):620–627

    PubMed  Google Scholar 

  5. Hoertel N, Limosin F, Leleu H (2014) Poor longitudinal continuity of care is associated with an increased mortality rate among patients with mental disorders: results from the French National Health Insurance Reimbursement Database. Eur Psychiatry 29(6):358–364

    CAS  PubMed  Google Scholar 

  6. Cohen CI, Meesters PD, Zhao J (2015) New perspectives on schizophrenia in later life: implications for treatment, policy, and research. Lancet Psychiatry 2(4):340–350

    PubMed  Google Scholar 

  7. Bachrach L (1996) Patients’quality of life: a continuing concern in the literature. Psychiatry Serv 47:1305–1306

    CAS  Google Scholar 

  8. Cohen CI, Vengassery A, Garcia Aracena EF (2017) A longitudinal analysis of quality of life and associated factors in older adults with schizophrenia spectrum disorder. Am J Geriatr Psychiatry 25(7):755–765

    PubMed  Google Scholar 

  9. Karow A, Wittmann L, Schöttle D, Schäfer I, Lambert M (2014) The assessment of quality of life in clinical practice in patients with schizophrenia. Dialogues Clin Neurosci 16(2):185–195

    PubMed  PubMed Central  Google Scholar 

  10. Cohen CI, Vahia I, Reyes P, Diwan S, Bankole AO, Palekar N, Kehn M, Ramirez P (2008) Focus on geriatric psychiatry: schizophrenia in later life: clinical symptoms and social well-being. Psychiatr Serv 59(3):232–234

    PubMed  Google Scholar 

  11. Fujimaki K, Morinobu S, Yamashita H, Takahashi T, Yamawaki S (2012) Predictors of quality of life in inpatients with schizophrenia. Psychiatry Res 197(3):199–205

    PubMed  Google Scholar 

  12. Kasckow J, Lanouette N, Patterson T, Fellows I, Golshan S, Solorzano E, Zisook S (2010) Treatment of subsyndromal depressive symptoms in middle-aged and older adults with schizophrenia: effect on functioning. Int J Geriatr Psychiatry 25(2):183–190

    PubMed  PubMed Central  Google Scholar 

  13. Tomida K, Takahashi N, Saito S, Maeno N, Iwamoto K, Yoshida K, Kimura H, Iidaka T, Ozaki N (2010) Relationship of psychopathological symptoms and cognitive function to subjective quality of life in patients with chronic schizophrenia. Psychiatry Clin Neurosci 64(1):62–69

    PubMed  Google Scholar 

  14. Cohen CI, Talavera N, Hartung R (1997) Predictors of subjective well-being among older, community-dwelling persons with schizophrenia. Am J Geriatr Psychiatry 5(2):145–155

    CAS  PubMed  Google Scholar 

  15. Eack SM, Newhill CE (2007) Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull 33(5):1225–1237

    PubMed  PubMed Central  Google Scholar 

  16. Shafer A (2005) Meta-analysis of the Brief Psychiatric Rating Scale factor structure. Psychol Assess 17(3):324–335

    PubMed  Google Scholar 

  17. Hoertel N, Franco S, Wall MM, Oquendo MA, Kerridge BT, Limosin F, Blanco C (2015) Mental disorders and risk of suicide attempt: a national prospective study. Mol Psychiatry 20(6):718–726

    CAS  PubMed  Google Scholar 

  18. Hoertel N, McMahon K, Olfson M, Wall MM, Rodríguez-Fernández JM, Lemogne C, Limosin F, Blanco C (2015) A dimensional liability model of age differences in mental disorder prevalence: evidence from a national sample. J Psychiatr Res 64:107–113

    PubMed  PubMed Central  Google Scholar 

  19. Diwan S, Cohen CI, Bankole AO, Vahia I, Kehn M, Ramirez PM (2007) Depression in older adults with schizophrenia spectrum disorders: prevalence and associated factors. Am J Geriatr Psychiatry 15(12):991–998

    PubMed  Google Scholar 

  20. Baernholdt M, Hinton I, Yan G, Rose K, Mattos M (2012) Factors associated with quality of life in older adults in the United States. Qual Life Res 21:527–534

    PubMed  Google Scholar 

  21. Cohen CI, Hassamal SK, Begum N (2011) General coping strategies and their impact on quality of life in older adults with schizophrenia. Schizophr Res 127(1–3):223–228

    PubMed  Google Scholar 

  22. Folsom DP, Depp C, Palmer BW, Mausbach BT, Golshan S, Fellows I, Cardenas V, Patterson TL, Kraemer HC, Jeste DV (2009) Physical and mental health-related quality of life among older people with schizophrenia. Schizophr Res 108(1–3):207–213

    PubMed  PubMed Central  Google Scholar 

  23. Roseman AS, Kasckow J, Fellows I, Osatuke K, Patterson TL, Mohamed S, Zisook S (2008) Insight, quality of life, and functional capacity in middle-aged and older adults with schizophrenia. Int J Geriatr Psychiatry 23(7):760–765

    PubMed  PubMed Central  Google Scholar 

  24. Bankole AO, Cohen CI, Vahia I, Diwan S, Kehn M, Ramirez PM (2007) Factors affecting quality of life in a multiracial sample of older persons with schizophrenia. Am J Geriatr Psychiatry 15(12):1015–1023

    PubMed  Google Scholar 

  25. Bartels SJ, Pratt SI (2009) Psychosocial rehabilitation and quality of life for older adults with serious mental illness: recent findings and future research directions. Curr Opin Psychiatry 22(4):381–385

    PubMed  PubMed Central  Google Scholar 

  26. van de Willige G, Wiersma D, Nienhuis FJ, Jenner JA (2005) Changes in quality of life in chronic psychiatric patients: a comparison between EuroQol (EQ-5D) and WHOQoL. Qual Life Res 14(2):441–451

    PubMed  Google Scholar 

  27. Bowie CR, Depp C, McGrath JA, Wolyniec P, Mausbach BT, Thornquist MH, Luke J, Patterson TL, Harvey PD, Pulver AE (2010) Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. Am J Psychiatry 167(9):1116–1124. https://doi.org/10.1176/appi.ajp.2010.09101406

    Article  PubMed  PubMed Central  Google Scholar 

  28. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198

    CAS  PubMed  Google Scholar 

  29. Ballesteros A, Sánchez-Torres AM, López-Ilundain JM, Cabrera B, Lobo A, González-Pinto AM, Díaz-Caneja C, Corripio I, Vieta E, de la Serna E, Bobes J, Usall J, Contreras F, Lorente-Omeñaca R, Mezquida G, Bernardo M, Cuesta MJ, PEPs Group (2018) Is cognitive impairment associated with antipsychotic dose and anticholinergic equivalent loads in first-episode psychosis? Psychol Med 48(13):2247–2256

    PubMed  Google Scholar 

  30. Alonso J, Croudace T, Brown J, Gasquet I, Knapp MR, Suárez D, Novick D (2009) Health-related quality of life (HRQL) and continuous antipsychotic treatment: 3-year results from the schizophrenia health outcomes (SOHO) study. Value Health 12:536–543

    PubMed  Google Scholar 

  31. Wehmeier PM, Kluge M, Schacht A, Helsberg K, Schreiber W, Schimmelmann BG, Lambert M (2008) Patterns of physician and patient rated quality of life during antipsychotic treatment in outpatients with schizophrenia. J Psychiatr Res 42(8):676–683

    PubMed  Google Scholar 

  32. Raucher-Chéné D, Hoertel N, Béra-Potelle C, Terrien S, Barrière S, Da Rin D, Tran E, Cuervo-Lombard C, Portefaix C, Limosin F (2015) Mental healthcare in older adults with schizophrenia: results from 118 French public psychiatric departments. Int Psychogeriatr 27(10):1749–1750

    PubMed  Google Scholar 

  33. Hoertel N, Jaffré C, Pascal de Raykeer R, McMahon K, Barrière S, Blumenstock Y, Portefaix C, Raucher-Chéné D, Béra-Potelle C, Cuervo-Lombard C, Chevance A, Guerin-Langlois C, Lemogne C, Airagnes G, Peyre H, Kaladjian A, Limosin F; CSA Study group. Subsyndromal and syndromal depressive symptoms among older adults with schizophrenia spectrum disorder: prevalence and associated factors in a multicenter study. J Affect Disord. 2019 Mar 6;251:60-70. https://doi.org/10.1016/j.jad.2019.03.007

  34. Schuster JP, Hoertel N, von Gunten A, Seigneurie AS, Limosin F, CSA Study group (2019) Benzodiazepine use among older adults with schizophrenia spectrum disorder: prevalence and associated factors in a multicenter study. Int Psychogeriatr. https://doi.org/10.1017/S1041610219000358

  35. Abou Kassma S, Hoertel N, Najaa W, McMahon K, Barrière S, Blumenstock Y, Portefaix C, Raucher-Chénée D, Béra-Potelle C, Cuervo-Lombard C, Guerin-Langlois C, Lemogne C, Peyre H, Kaladjian A, Limosin F, CSA Study group (2019) Metabolic syndrome among older adults with schizophrenia spectrum disorder: prevalence and associated factors in a multicenter study. Psychiatry Res 275:238–246. https://doi.org/10.1016/j.psychres.2019.03.036

    Article  Google Scholar 

  36. Heinrichs DW, Hanlon TE, Carpenter WT Jr (1984) The quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 10(3):388–398

    CAS  PubMed  Google Scholar 

  37. Lehman AF (1996) Measures of quality of life among persons with severe and persistent mental disorders. Soc Psychiatry Psychiatr Epidemiol 31(2):78–88

    CAS  PubMed  Google Scholar 

  38. Overall JE, Gorham DR (1988) The Brief Psychiatric Rating Scale (BPRS): recent developments in ascertainment and scaling. Psychopharmacol Bull 24(1):97–99

    Google Scholar 

  39. Overall JE, Gorham DR (1962) The Brief Psychiatric Rating Scale. Psychol Rep 10(3):799–812

    Google Scholar 

  40. Pichot P, Overall JE, Samuel-Lajeunesse B, Drefus JF (1969) Structure factorielle de l’échelle abrégée d’appréciation psychiatrique. Rev Psychol Appl 19:218–232

    Google Scholar 

  41. Faustman WO, Overall JE (1999) Brief Psychiatric Rating Scale

  42. Yee A, Ng BS, Hashim HMH, Danaee M, Loh HH (2017) Cultural adaptation and validity of the Malay version of the Brief Psychiatric Rating Scale (BPRS-M) among patients with schizophrenia in a psychiatric clinic. BMC Psychiatry 17(1):384

    PubMed  PubMed Central  Google Scholar 

  43. Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA (2014) BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr 99(4):875–890

    CAS  PubMed  Google Scholar 

  44. Herz MI, Liberman RP, McGlashan TH, Lieberman JA, Wyatt RJ, Marder SR, Bellack AS (1997) Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 154(4 SUPPL.):1–63

    Google Scholar 

  45. Woods SW (2003) Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 64:663–667

    CAS  PubMed  Google Scholar 

  46. Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6:1–55

    Google Scholar 

  47. Pascal de Raykeer R, Hoertel N, Blanco C, Olfson M, Wall M, Seigneurie AS, Schuster JP, Lemogne C, von Gunten A, Limosin F (2018) Effects of psychiatric disorders on suicide attempt: similarities and differences between older and younger adults in a National Cohort Study. J Clin Psychiatry 79(6):pii: 17m11911

  48. Hoertel N, Faiz H, Airagnes G, Blanco C, Pascal De Raykeer R, Franco S, Ducoutumany G, Lemogne C, Limosin F (2018) A comprehensive model of predictors of suicide attempt in heavy drinkers: results from a national 3-year longitudinal study. Drug Alcohol Depend 186:44–52

    PubMed  Google Scholar 

  49. Hoertel N, Blanco C, Oquendo MA, Wall MM, Olfson M, Falissard B, Franco S, Peyre H, Lemogne C, Limosin F (2017) A comprehensive model of predictors of persistence and recurrence in adults with major depression: results from a national 3-year prospective study. J Psychiatr Res 95:19–27

    PubMed  PubMed Central  Google Scholar 

  50. Hoertel N, Franco S, Wall MM, Oquendo MA, Wang S, Limosin F, Blanco C (2015) Childhood maltreatment and risk of suicide attempt: a nationally representative study. J Clin Psychiatry 76(7):916–923 quiz 923

    PubMed  Google Scholar 

  51. Hoertel N, Blanco C, Olfson M, Oquendo MA, Wall MM, Franco S, Leleu H, Lemogne C, Falissard B, Limosin F (2018a) A comprehensive model of predictors of suicide attempt in depressed individuals and effect of treatment-seeking behavior: results from a national 3-year prospective study. J Clin Psychiatry 79(5):pii: 17m11704

  52. McMahon K, Hoertel N, Olfson M, Wall M, Wang S, Blanco C (2018) Childhood maltreatment and impulsivity as predictors of interpersonal violence, self-injury and suicide attempts: a national study. Psychiatry Res 269:386–393. https://doi.org/10.1016/j.psychres.2018.08.059

    Article  PubMed  PubMed Central  Google Scholar 

  53. McMahon K, Hoertel N, Wall MM, Okuda M, Limosin F, Blanco C (2015) Childhood maltreatment and risk of intimate partner violence: a national study. J Psychiatr Res 69:42–49. https://doi.org/10.1016/j.jpsychires.2015.07.026

    Article  PubMed  PubMed Central  Google Scholar 

  54. Meneton P, Hoertel N, Wiernik E, Lemogne C, Ribet C, Bonenfant S, Ménard J, Goldberg M, Zins M (2018) Work environment mediates a large part of social inequalities in the incidence of several common cardiovascular risk factors: findings from the Gazel cohort. Soc Sci Med 216:59–66

    PubMed  Google Scholar 

  55. Muthen LK, Muthen BO (1998-2006) Mplus User’s Guide Los Angeles

  56. Schafer JL (1997) Analysis of incomplete multivariate data. Chapman and Hall/CRC, London

    Google Scholar 

  57. Caspi A, Moffitt TE (2018) All for one and one for all: mental disorders in one dimension. Am J Psychiatry 175(9):831–844. https://doi.org/10.1176/appi.ajp.2018.17121383

    Article  PubMed  PubMed Central  Google Scholar 

  58. Krueger RF, Eaton NR (2015) Transdiagnostic factors of mental disorders. World Psychiatry 14(1):27–29. https://doi.org/10.1002/wps.20175

    Article  PubMed  PubMed Central  Google Scholar 

  59. Kotov R, Ruggero CJ, Krueger RF, Watson D, Yuan Q, Zimmerman M (2011) New dimensions in the quantitative classification of mental illness. Arch Gen Psychiatry 68(10):1003–1011

    PubMed  Google Scholar 

  60. Kotov R, Chang SW, Fochtmann LJ, Mojtabai R, Carlson GA, Sedler MJ, Bromet E (2011) Schizophrenia in the internalizing-externalizing framework: a third dimension? Schizophr Bull 37:1168–1178

    PubMed  Google Scholar 

  61. Andreasen NC, Olsen S (1982) Negative v positive schizophrenia. Definition and validation. Arch Gen Psychiatry 39(7):789–794

    CAS  PubMed  Google Scholar 

  62. Crow TJ (1980) Molecular pathology of schizophrenia: more than one disease process? Br Med J 280(6207):66–68

    CAS  PubMed  PubMed Central  Google Scholar 

  63. Andreasen NC, Arndt S, Alliger R, Pharmed DM, Flaum M (1995) Symptoms of schizophrenia: methods, meanings, and mechanisms. Arch Gen Psychiatry 52:341–351

    CAS  PubMed  Google Scholar 

  64. Grube BS, Bilder RM, Goldman RS (1998) Meta-analysis of symptom factors in schizophrenia. Schizophr Res 31:113–120

    CAS  PubMed  Google Scholar 

  65. Kring AM, Gur RE, Blanchard JJ, Horan WP, Reise SP (2013) The clinical assessment interview for negative symptoms (CAINS): final development and validation. Am J Psychiatry 170:165–172

    PubMed  PubMed Central  Google Scholar 

  66. Strauss GP, Horan WP, Kirkpatrick B, Fischer BA, Keller WR, Miski P, Buchanan RW, Green MF, Carpenter WT Jr (2013) Deconstructing negative symptoms of schizophrenia: avolition-apathy and diminished expression clusters predict clinical presentation and functional outcome. J Psychiatr Res 47(6):783–790. https://doi.org/10.1016/j.jpsychires.2013.01.015

    Article  PubMed  PubMed Central  Google Scholar 

  67. Kotov R, Foti D, Li K, Bromet EJ, Hajcak G, Ruggero CJ (2016) Validating dimensions of psychosis symptomatology: neural correlates and 20-year outcomes. J Abnorm Psychol 125(8):1103–1119. https://doi.org/10.1037/abn0000188

    Article  PubMed  PubMed Central  Google Scholar 

  68. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5. Washington, DC: Author; 2013

  69. Norman RM, Malla AK, McLean T, Voruganti LP, Cortese L, McIntosh E, Cheng S, Rickwood A (2000) The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the quality of life scale. Acta Psychiatr Scand 102(4):303–309

    CAS  PubMed  Google Scholar 

  70. Aki H, Tomotake M, Kaneda Y, Iga J, Kinouchi S, Shibuya-Tayoshi S, Tayoshi SY, Motoki I, Moriguchi K, Sumitani S, Yamauchi K, Taniguchi T, Ishimoto Y, Ueno S, Ohmori T (2008) Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia. Psychiatry Res 158:19–25

    PubMed  Google Scholar 

  71. Fitzgerald PB, de Castella AR, Filia K, Collins J, Brewer K, Williams CL, Davey P, Kulkarni J (2003) A longitudinal study of patient- and observer-rated quality of life in schizophrenia. Psychiatry Res 119(1–2):55–62

    PubMed  Google Scholar 

  72. Galderisi S, Mucci A, Buchanan RW, Arango C (2018) Negative symptoms of schizophrenia: new developments and unanswered research questions. Lancet Psychiatry 5(8):664–677

    PubMed  Google Scholar 

  73. Tomotake M, Kaneda Y, Iga J, Kinouchi S, Tayoshi S, Motoki I, Sumitani S, Yamauchi K, Taniguchi T, Ishimoto Y, Ueno S, Ohmori T (2006) Subjective and objective measures of quality of life have different predictors for people with schizophrenia. Psychol Rep 99(2):477–487

    PubMed  Google Scholar 

  74. Fitzgerald PB, Williams CL, Corteling N, Filia SL, Brewer K, Adams A, de Castella AR, Rolfe T, Davey P, Kulkarni J (2001) Subject and observer-rated quality of life in schizophrenia. Acta Psychiatr Scand 103(5):387–392

    CAS  PubMed  Google Scholar 

  75. Huppert JD, Smith TE (2001) Longitudinal analysis of subjective quality of life in schizophrenia: anxiety as the best symptom predictor. J Nerv Ment Dis 189(10):669–675

    CAS  PubMed  Google Scholar 

  76. Jin H, Zisook S, Palmer BW, Patterson TL, Heaton RK, Jeste DV (2001) Association of depressive symptoms with worse functioning in schizophrenia: a study in older outpatients. J Clin Psychiatry 62(10):797–803

    CAS  PubMed  Google Scholar 

  77. Reine G, Lançon C, Di Tucci S, Sapin C, Auquier P (2003) Depression and subjective quality of life in chronic phase schizophrenic patients. Acta Psychiatr Scand 108(4):297–303

    CAS  PubMed  Google Scholar 

  78. Awad AG, Voruganti LN, Heslegrave RJ (1997) A conceptual model of quality of life in schizophrenia: description and preliminary clinical validation. Qual Life Res 6(1):21–26

    CAS  PubMed  Google Scholar 

  79. Lang UE, Puls I, Muller DJ, Strutz-Seebohm N, Gallinat J (2007) Molecular mechanisms of schizophrenia. Cell Physiol Biochem 20(6):687–702

    CAS  PubMed  Google Scholar 

  80. Fabbri C, Serretti A (2017) Role of 108 schizophrenia-associated loci in modulating psychopathological dimensions in schizophrenia and bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 174(7):757–764

    CAS  PubMed  Google Scholar 

  81. McGrath LM, Cornelis MC, Lee PH, Robinson EB, Duncan LE, Barnett JH, Huang J, Gerber G, Sklar P, Sullivan P, Perlis RH, Smoller JW (2013) Genetic predictors of risk and resilience in psychiatric disorders: a cross-disorder genome-wide association study of functional impairment in major depressive disorder, bipolar disorder, and schizophrenia. Am J Med Genet B Neuropsychiatr Genet 162B(8):779–788

    PubMed  Google Scholar 

  82. Schoormans D, Li J, Darabi H, Brandberg Y, Sprangers MA, Eriksson M, Zwinderman KH, Hall P (2015) The genetic basis of quality of life in healthy Swedish women: a candidate gene approach. PLoS ONE 10(2):e0118292

    PubMed  PubMed Central  Google Scholar 

  83. Akanji AO, Ohaeri JU, Al-Shammri S, Fatania HR (2009) Association of blood levels of C-reactive protein with clinical phenotypes in Arab schizophrenic patients. Psychiatry Res 169:56–61. https://doi.org/10.1016/j.psychres.2008.06.010

    Article  CAS  PubMed  Google Scholar 

  84. Fan X, Pristach C, Liu EY, Freudenreich O, Henderson DC, Goff DC (2007) Elevated serum levels of C-reactive protein are associated with more severe psychopathology in a subgroup of patients with schizophrenia. Psychiatry Res 149(1–3):267–271

    CAS  PubMed  Google Scholar 

  85. Flatow J, Buckley P, Miller BJ (2013) Meta-analysis of oxidative stress in schizophrenia. Biol Psychiatry 74(6):400–409

    CAS  PubMed  PubMed Central  Google Scholar 

  86. Miller BJ, Culpepper N, Rapaport MH (2014) C-reactive protein levels in schizophrenia: a review and meta-analysis. Clin Schizophr Relat Psychoses 7(4):223–230

    PubMed  Google Scholar 

  87. Müller N (2018) Inflammation in schizophrenia: pathogenetic aspects and therapeutic considerations. Schizophr Bull 44(5):973–982

    PubMed  PubMed Central  Google Scholar 

  88. Faugere M, Micoulaud-Franchi JA, Alessandrini M, Richieri R, Faget-Agius C, Auquier P, Lançon C, Boyer L (2015) Quality of life is associated with chronic inflammation in schizophrenia: a cross-sectional study. Sci Rep 5:10793

    CAS  PubMed  Google Scholar 

  89. Morrison AS, Mateen MA, Brozovich FA, Zaki J, Goldin PR, Heimberg RG, Gross JJ (2016) Empathy for positive and negative emotions in social anxiety disorder. Behav Res Ther 87:232–242

    PubMed  PubMed Central  Google Scholar 

  90. Park IJ, Chung Jung D, Suk-Hyun Hwang S, Yeon Jung H, Yoon JS, Kim CE, Min Ahn Y, Sik Kim Y (2016) Longitudinal relationship between Personal and Social Performance (PSP) and anxiety symptoms in schizophrenia. J Affect Disord 190:12–18

    PubMed  Google Scholar 

  91. Hunter R, Barry S (2012) Negative symptoms and psychosocial functioning in schizophrenia: neglected but important targets for treatment. Eur Psychiatry 27(6):432–436

    CAS  PubMed  Google Scholar 

  92. Seedat S, Fritelli V, Oosthuizen P, Emsley RA, Stein DJ (2007) Measuring anxiety in patients with schizophrenia. J Nerv Ment Dis 195(4):320–324

    PubMed  Google Scholar 

  93. Mittal D, Davis CE, Depp C, Pyne JM, Golshan S, Patterson TL, Jeste DV (2006) Correlates of health-related quality of well-being in older patients with schizophrenia. J Nerv Ment Dis 194(5):335–340

    PubMed  Google Scholar 

  94. Sciolla A, Patterson TL, Wetherell JL, McAdams LA, Jeste DV (2003) Functioning and well-being of middle-aged and older patients with schizophrenia: measurement with the 36-item short-form (SF-36) health survey. Am J Geriatr Psychiatry 11(6):629–637

    PubMed  Google Scholar 

  95. Tolman AW, Kurtz MM (2012) Neurocognitive predictors of objective and subjective quality of life in individuals with schizophrenia: a meta-analytic investigation. Schizophr Bull 38(2):304–315

    PubMed  Google Scholar 

  96. Buchanan J (1995) Social support and schizophrenia: a review of the literature. Arch Psychiatr Nurs 9:68–76

    CAS  PubMed  Google Scholar 

  97. Morse G, Calsyn RJ (1985) Mentally disturbed homeless people in St. Louis: needy, willing, but underserved. Int J Mental Health 14(4):74–94

    Google Scholar 

  98. Patterson TL, Shaw W, Semple SJ, Moscona S, Harris MJ, Kaplan RM, Grant I, Jeste DV (1997) Health-related quality of life in older patients with schizophrenia and other psychoses: relationships among psychosocial and psychiatric factors. Int J Geriatr Psychiatry 12(4):452–461

    CAS  PubMed  Google Scholar 

  99. Ho BC, Nopoulos P, Flaum M, Arndt S, Andreasen NC (1998) Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. Am J Psychiatry 155(9):1196–1201

    CAS  PubMed  Google Scholar 

  100. Neil AL, Carr VJ, Mackinnon A, Foley DL, Morgan VA (2018) Health-related quality of life in people living with psychotic illness and factors associated with its variation. Value Health 21(8):1002–1009

    PubMed  Google Scholar 

  101. Packer S, Husted J, Cohen S, Tomlinson G (1997) Psychopathology and quality of life in schizophrenia. J Psychiatry Neurosci 22(4):231–234

    CAS  PubMed  PubMed Central  Google Scholar 

  102. Marder SR, Galderisi S (2017) The current conceptualization of negative symptoms in schizophrenia. World Psychiatry 16(1):14–24

    PubMed  PubMed Central  Google Scholar 

  103. Strauss GP, Cohen AS (2017) A transdiagnostic review of negative symptom phenomenology and etiology. Schizophr Bull 43(4):712–719

    PubMed  PubMed Central  Google Scholar 

  104. Barch DM, Pagliaccio D, Luking K (2016) Mechanisms underlying motivational deficits in psychopathology: similarities and differences in depression and schizophrenia. Curr Top Behav Neurosci 27:411–449

    PubMed  Google Scholar 

  105. Bromberg-Martin ES, Matsumoto M, Hikosaka O (2010) Dopamine in motivational control: rewarding, aversive, and alerting. Neuron 68:815–834

    CAS  PubMed  PubMed Central  Google Scholar 

  106. Kapur S (2003) Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 160(1):13–23

    PubMed  Google Scholar 

  107. Kring AM, Barch DM (2014) The motivation and pleasure dimension of negative symptoms: neural substrates and behavioral outputs. Eur Neuropsychopharmacol 24(5):725–736

    CAS  PubMed  PubMed Central  Google Scholar 

  108. Morris RW, Quail S, Griffiths KR, Green MJ, Balleine BW (2015) Corticostriatal control of goal-directed action is impaired in schizophrenia. Biol Psychiatry 77(2):187–195

    PubMed  Google Scholar 

  109. Mucci A, Dima D, Soricelli A, Volpe U, Bucci P, Frangou S, Prinster A, Salvatore M, Galderisi S, Maj M (2015) Is avolition in schizophrenia associated with a deficit of dorsal caudate activity? A functional magnetic resonance imaging study during reward anticipation and feedback. Psychol Med 45(8):1765–1778

    CAS  PubMed  PubMed Central  Google Scholar 

  110. Radua J, Schmidt A, Borgwardt S, Heinz A, Schlagenhauf F, McGuire P, Fusar-Poli P (2015) Ventral striatal activation during reward processing in psychosis: a neurofunctional meta-analysis. JAMA Psychiatry 72(12):1243–1251

    PubMed  Google Scholar 

  111. Salamone JD, Yohn SE, López-Cruz L, San Miguel N, Correa M (2016) Activational and effort-related aspects of motivation: neural mechanisms and implications for psychopathology. Brain 139(Pt 5):1325–1347

    PubMed  PubMed Central  Google Scholar 

  112. Bucci P, Piegari G, Chieffi M, Mucci A, Galderisi S, Maj M (2013) 2304–Relationships between psychopathological dimensions, cognitive deficits and functional capacity/real-life functioning in patients with schizophrenia. Eur Psychiatry 28:1

    Google Scholar 

  113. Montemagni C, Castagna F, Crivelli B, De Marzi G, Frieri T, Macrì A, Rocca P (2014) Relative contributions of negative symptoms, insight, and coping strategies to quality of life in stable schizophrenia. Psychiatry Res 220(1–2):102–111

    PubMed  Google Scholar 

  114. Rocca P, Montemagni C, Zappia S, Piterà R, Sigaudo M, Bogetto F (2014) Negative symptoms and everyday functioning in schizophrenia: a cross-sectional study in a real world-setting. Psychiatry Res 218(3):284–289

    PubMed  Google Scholar 

  115. Fiorillo D, Sabatini F (2011) Quality and quantity: the role of social interactions in self-reported individual health. Soc Sci Med 73(11):1644–1652

    PubMed  Google Scholar 

  116. Blanco C, Krueger RF, Hasin DS, Liu SM, Wang S, Kerridge BT, Saha T, Olfson M (2013) Mapping common psychiatric disorders: structure and predictive validity in the national epidemiologic survey on alcohol and related conditions. JAMA Psychiatry 70(2):199–208. https://doi.org/10.1001/jamapsychiatry.2013.281

    Article  PubMed  PubMed Central  Google Scholar 

  117. Eaton NR, Keyes KM, Krueger RF, Balsis S, Skodol AE, Markon KE, Grant BF, Hasin DS (2012) An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. J Abnorm Psychol 121(1):282–288. https://doi.org/10.1037/a0024780

    Article  PubMed  Google Scholar 

  118. Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, Sanislow C, Wang P (2010) Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 167(7):748–751

    PubMed  Google Scholar 

  119. Kessler RC, Ormel J, Petukhova M, McLaughlin KA, Green JG, Russo LJ, Stein DJ, Zaslavsky AM, Aguilar-Gaxiola S, Alonso J, Andrade L, Benjet C, de Girolamo G, de Graaf R, Demyttenaere K, Fayyad J, Haro JM, Cy Hu, Karam A, Lee S, Lepine JP, Matchsinger H, Mihaescu-Pintia C, Posada-Villa J, Sagar R, Ustün TB (2011) Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 68(1):90–100

    PubMed  PubMed Central  Google Scholar 

  120. Krueger RF (1999) The structure of common mental disorders. Arch Gen Psychiatry 56(10):921–926

    CAS  PubMed  Google Scholar 

  121. Vollebergh WA, Iedema J, Bijl RV, de Graaf R, Smit F, Ormel J (2001) The structure and stability of common mental disorders: the NEMESIS study. Arch Gen Psychiatry 58(6):597–603

    CAS  PubMed  Google Scholar 

  122. Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A, Carl JR, Boettcher HT, Cassiello-Robbins C (2017) The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a randomized clinical trial. JAMA Psychiatry 74(9):875–884

    PubMed  PubMed Central  Google Scholar 

  123. Le Strat Y, Hoertel N (2011) Correlation is no causation: gymnasium proliferation and the risk of obesity. Addiction 106(10):1871–1872

    PubMed  Google Scholar 

  124. Nordgaard J, Revsbech R, Sæbye D, Parnas J (2012) Assessing the diagnostic validity of a structured psychiatric interview in a first-admission hospital sample. World Psychiatry 11(3):181–185

    PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This study was supported by a grant from the French Ministry of Health and Social Affairs (PHRC 2008-N11-01) (http://solidarites-sante.gouv.fr/) and the French Psychiatric Congress (http://www.congresfrancaispsychiatrie.org). It was promoted by the University of Reims Champagne-Ardenne (http://www.univ-reims.fr/) and the University Paris-Descartes (https://www.univ-paris5.fr/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank the Clinical Research Unit of Georges Pompidou European Hospital, and in particular Pr Gilles Chatellier, Mr Yvann Frigout and Mrs Pascaline Aucouturier, and the Clinical Research Unit of Robert Debré Hospital, and in particular Mrs Sarah Rubingher, Dr Bérengère Hubsch, Dr Eric Tran, Dr Fabien Gierski and Mr David Da Rin. We warmly thank all the patients and the investigators who made this study possible.

Members of the CSA (Cohort of individuals with Schizophrenia Aged 55 years or more) Study group are: Jean Adès, Charles Alezrah, Isabelle Amado, Gilles Amar, Ovidiu Andréi, Denis Arbault, Georges Archambault, Gilles Aurifeuille, Sarah Barrière, Céline Béra-Potelle, Yvonne Blumenstock, Hervé Bardou, Michèle Bareil-Guérin, Pierre Barrau, Claudine Barrouillet, Emilie Baup, Nadine Bazin, Béatrice Beaufils, Jalel Ben Ayed, Michel Benoit, Kader Benyacoub, Thérèse Bichet, Françoise Blanadet, Olivier Blanc, Julien Blanc-Comiti, Didier Boussiron, Anne-Marie Bouysse, Alain Brochard, Olivier Brochart, Bastien Bucheron, Marion Cabot, Vincent Camus, Jean-Marc Chabannes, Véronique Charlot, Thomas Charpeaud, Cateline Clad-Mor, Colette Combes, Maricela Comisu, Bernard Cordier, François Costi, Jean-Paul Courcelles, Mercedes Creixell, Henry Cuche, Christine Cuervo-Lombard, Anis Dammak, David Da Rin, Jean-Bernard Denis, Hélène Denizot, Anne Deperthuis, Eric Diers, Smail Dirami, Didier Donneau, Pierre Dreano, Caroline Dubertret, Eric Duprat, Didier Duthoit, Christian Fernandez, Philippe Fonfrede, Nelly Freitas, Philippe Gasnier, Jacques Gauillard, Fabien Getten, Fabien Gierski, Fabien Godart, Raphaël Gourevitch, Aude Grassin Delyle, Juliette Gremion, Hélène Gres, Véronique Griner, Christophe Guerin-Langlois, Christian Guggiari, Olivier Guillin, Hamadi Hadaoui, Emmanuel Haffen, Sadeq Haouzir, Cyril Hazif-Thomas, Anne Heron, Bérengère Hubsch, Isabelle Jalenques, Dominique Januel, Jean-François Karnycheff, Oussama Kebir, Marie-Odile Krebs, Christine Lajugie, Marion Leboyer, Pierre Legrand, Michel Lejoyeux, Vincent Lemaire, Evelyne Leroy, Diane Levy-Chavagnat, Antoine Leydier, Chantal Liling, Pierre-Michel Llorca, Philippe Loeffel, Patrice Louville, Stéphane Lucas Navarro, Nicolas Mages, Mohamed Mahi, Odile Maillet, Aude Manetti, Catherine Martelli, Pascal Martin, Marc Masson, Isabelle Maurs-Ferrer, Joelle Mauvieux, Sylvain Mazmanian, Emmanuelle Mechin, Lila Mekaoui, Mostéfa Meniai, Agnès Metton, Amine Mihoubi, Maria Miron, Geneviève Mora, Valérie Niro Adès, Philippe Nubukpo, Cécile Omnes, Stéphanie Papin, Pierre Paris, Christine Passerieux, Jérôme Pellerin, Julie Perlbarg, Sylvie Perron, Annie Petit, François Petitjean, Christophe Portefaix, Dominique Pringuey, Andrei Radtchenko, Hassan Rahiou, Delphine Raucher-Chéné, Anne Rauzy, Lionel Reinheimer, Michel Renard, Margaux René, Charles-Edouard Rengade, Paul Reynaud, Didier Robin, Christelle Rodrigues, Aurélie Rollet, Fabien Rondepierre, Bernard Rousselot, Sarah Rubingher, Ghassen Saba, Jean-Pierre Salvarelli, Jean-Claude Samuelian, Corinne Scemama-Ammar, Franck Schurhoff, Jean-Pierre Schuster, Daniel Sechter, Béatrice Segalas, Tiphaine Seguret, Anne-Sophie Seigneurie, Amina Semmak, Frédéric Slama, Sophie Taisne, Mohamed Taleb, Jean-Louis Terra, Dominique Thefenne, Eric Tran, Rémi Tourtauchaux, Marie-Noëlle Vacheron, Pierre Vandel, Valérie Vanhoucke, Emmanuel Venet, Hélène Verdoux, Anne Viala, Gilles Vidon, Murielle Vitre, Jean-Luc Vurpas, Carole Wagermez, Michel Walter, Liova Yon, Xavier Zendjidjian.

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Authors and Affiliations

  1. Department of Psychiatry, AP-HP, Western Paris University Hospitals, Corentin Celton Hospital, 92130 Issy-les-Moulineaux, France

    Nicolas Hoertel, Léa Rotenberg, Rachel Pascal de Raykeer, Cécile Hanon & Frédéric Limosin

  2. Psychiatry and Neurosciences Center, INSERM UMR 894, Paris, France

    Nicolas Hoertel & Frédéric Limosin

  3. Sorbonne Paris Cité, Paris Descartes University, Paris, France

    Nicolas Hoertel & Frédéric Limosin

  4. Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA

    Carlos Blanco

  5. Department of Psychiatry, Robert Debré Hospital, Reims University Hospital, Reims, France

    Arthur Kaladjian

  6. Cognition, Health and Socialization Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France

    Arthur Kaladjian

Authors
  1. Nicolas Hoertel
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  2. Léa Rotenberg
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  3. Carlos Blanco
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  4. Rachel Pascal de Raykeer
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  5. Cécile Hanon
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  6. Arthur Kaladjian
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  7. Frédéric Limosin
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Consortia

CSA Study Group

  • Jean Adès
  • , Charles Alezrah
  • , Isabelle Amado
  • , Gilles Amar
  • , Ovidiu Andréi
  • , Denis Arbault
  • , Georges Archambault
  • , Gilles Aurifeuille
  • , Sarah Barrière
  • , Céline Béra-Potelle
  • , Yvonne Blumenstock
  • , Hervé Bardou
  • , Michèle Bareil-Guérin
  • , Pierre Barrau
  • , Claudine Barrouillet
  • , Emilie Baup
  • , Nadine Bazin
  • , Béatrice Beaufils
  • , Jalel Ben Ayed
  • , Michel Benoit
  • , Kader Benyacoub
  • , Thérèse Bichet
  • , Françoise Blanadet
  • , Olivier Blanc
  • , Julien Blanc-Comiti
  • , Didier Boussiron
  • , Anne-Marie Bouysse
  • , Alain Brochard
  • , Olivier Brochart
  • , Bastien Bucheron
  • , Marion Cabot
  • , Vincent Camus
  • , Jean-Marc Chabannes
  • , Véronique Charlot
  • , Thomas Charpeaud
  • , Cateline Clad-Mor
  • , Colette Combes
  • , Maricela Comisu
  • , Bernard Cordier
  • , François Costi
  • , Jean-Paul Courcelles
  • , Mercedes Creixell
  • , Henry Cuche
  • , Christine Cuervo-Lombard
  • , Anis Dammak
  • , David Da Rin
  • , Jean-Bernard Denis
  • , Hélène Denizot
  • , Anne Deperthuis
  • , Eric Diers
  • , Smail Dirami
  • , Didier Donneau
  • , Pierre Dreano
  • , Caroline Dubertret
  • , Eric Duprat
  • , Didier Duthoit
  • , Christian Fernandez
  • , Philippe Fonfrede
  • , Nelly Freitas
  • , Philippe Gasnier
  • , Jacques Gauillard
  • , Fabien Getten
  • , Fabien Gierski
  • , Fabien Godart
  • , Raphaël Gourevitch
  • , Aude Grassin Delyle
  • , Juliette Gremion
  • , Hélène Gres
  • , Véronique Griner
  • , Christophe Guerin-Langlois
  • , Christian Guggiari
  • , Olivier Guillin
  • , Hamadi Hadaoui
  • , Emmanuel Haffen
  • , Sadeq Haouzir
  • , Cyril Hazif-Thomas
  • , Anne Heron
  • , Bérengère Hubsch
  • , Isabelle Jalenques
  • , Dominique Januel
  • , Jean-François Karnycheff
  • , Oussama Kebir
  • , Marie-Odile Krebs
  • , Christine Lajugie
  • , Marion Leboyer
  • , Pierre Legrand
  • , Michel Lejoyeux
  • , Vincent Lemaire
  • , Evelyne Leroy
  • , Diane Levy-Chavagnat
  • , Antoine Leydier
  • , Chantal Liling
  • , Pierre-Michel Llorca
  • , Philippe Loeffel
  • , Patrice Louville
  • , Stéphane Lucas Navarro
  • , Nicolas Mages
  • , Mohamed Mahi
  • , Odile Maillet
  • , Aude Manetti
  • , Catherine Martelli
  • , Pascal Martin
  • , Marc Masson
  • , Isabelle Maurs-Ferrer
  • , Joelle Mauvieux
  • , Sylvain Mazmanian
  • , Emmanuelle Mechin
  • , Lila Mekaoui
  • , Mostéfa Meniai
  • , Agnès Metton
  • , Amine Mihoubi
  • , Maria Miron
  • , Geneviève Mora
  • , Valérie Niro Adès
  • , Philippe Nubukpo
  • , Cécile Omnes
  • , Stéphanie Papin
  • , Pierre Paris
  • , Christine Passerieux
  • , Jérôme Pellerin
  • , Julie Perlbarg
  • , Sylvie Perron
  • , Annie Petit
  • , François Petitjean
  • , Christophe Portefaix
  • , Dominique Pringuey
  • , Andrei Radtchenko
  • , Hassan Rahiou
  • , Delphine Raucher-Chéné
  • , Anne Rauzy
  • , Lionel Reinheimer
  • , Michel Renard
  • , Margaux René
  • , Charles-Edouard Rengade
  • , Paul Reynaud
  • , Didier Robin
  • , Christelle Rodrigues
  • , Aurélie Rollet
  • , Fabien Rondepierre
  • , Bernard Rousselot
  • , Sarah Rubingher
  • , Ghassen Saba
  • , Jean-Pierre Salvarelli
  • , Jean-Claude Samuelian
  • , Corinne Scemama-Ammar
  • , Franck Schurhoff
  • , Jean-Pierre Schuster
  • , Daniel Sechter
  • , Béatrice Segalas
  • , Tiphaine Seguret
  • , Anne-Sophie Seigneurie
  • , Amina Semmak
  • , Frédéric Slama
  • , Sophie Taisne
  • , Mohamed Taleb
  • , Jean-Louis Terra
  • , Dominique Thefenne
  • , Eric Tran
  • , Rémi Tourtauchaux
  • , Marie-Noëlle Vacheron
  • , Pierre Vandel
  • , Valérie Vanhoucke
  • , Emmanuel Venet
  • , Hélène Verdoux
  • , Anne Viala
  • , Gilles Vidon
  • , Murielle Vitre
  • , Jean-Luc Vurpas
  • , Carole Wagermez
  • , Michel Walter
  • , Liova Yon
  •  & Xavier Zendjidjian

Contributions

NH and FL designed the study. FL obtained the funding. LR and NH undertook statistical analyses. NH and LR wrote the first draft of the manuscript. CB, RPDR, CH, AK and FL critically reviewed the manuscript. All authors contributed to and have approved the final manuscript.

Corresponding author

Correspondence to Nicolas Hoertel.

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Conflict of interest

This study did not involve any pharmaceutical companies or other private enterprises. FL has received speaker and consulting fees from AstraZeneca, Janssen, Lundbeck, Otsuka Pharmaceuticals, Roche and Servier. Other authors (NH, LR, CB, RPDR, CH, and AK) report no conflicts of interest relevant to the content of this article.

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Hoertel, N., Rotenberg, L., Blanco, C. et al. Psychiatric symptoms and quality of life in older adults with schizophrenia spectrum disorder: results from a multicenter study. Eur Arch Psychiatry Clin Neurosci 270, 673–688 (2020). https://doi.org/10.1007/s00406-019-01026-9

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