Cortisol response and coping style predict quality of life in schizophrenia.

Stress and coping have been found to be strongly associated with quality of life (QOL). Compared to community controls (CC), individuals diagnosed with schizophrenia (SZ) report a lower QOL. Lower QOL in SZ may be explained by patients' tendency to react differently to stress and to use less effective coping strategies than CC, but no studies to date have examined these possible associations. A main goal of this study, therefore, was to examine the roles of stress response and coping style in explaining QOL in SZ and CC, while controlling for potential confounds including personality. Subjects were 30 SZ patients and 29 matched controls who completed the Trier Social Stress Test (TSST). Salivary cortisol was used as an objective measure of stress response. Participants rated their coping strategies with the Brief COPE, judged their QOL with the Satisfaction with Life Scale, and rated their personality using the NEO-Five Factor Inventory. Results indicate that, even when confounds are controlled for, blunted cortisol response predicts better QOL in SZ patients. Additionally, results suggest that more frequent use of coping strategies is associated with better QOL but only in patients with blunted cortisol response; those who showed an increase in cortisol in response to the TSST have better QOL the lower their coping score. Possible explanations and clinical implications of these findings are discussed.

Validation of the English and French versions of the Community Assessment of Psychic Experiences (CAPE) with a Montreal community sample.

OBJECTIVE: The aim of this study was to examine the reliability, validity and factor structure of the Community Assessment of Psychic Experiences (CAPE), a 42-item self-report questionnaire. We analyzed the internal consistency of the CAPE to determine whether the 3-factor structure (positive, negative and depressive symptoms) found by the CAPE authors would also be found in our sample. METHOD: A sample of 2275 individuals from the general community in the Montreal area completed the questionnaire in either French or English. RESULTS: The internal consistencies of the original three subscales were good and the confirmatory factor models had a good fit. The exploratory factor analysis suggested a 3-5-factor solution, without improving the alternative factor structures. The 4-factor solution separated positive symptoms into factors we called 'bizarre positive symptoms' and 'social delusions', and the 5-factor solution separated positive symptoms further and included a 'popular psychic beliefs' factor. Results suggest that the scalability might be improved by shortening the original questionnaire to 23 items with the same 3 original scales. CONCLUSION: We support the internal consistency of the CAPE. Although alternative scaling (4 and 5 factors) did not improve the model fit, researchers interested in distinguishing 3 factors of positive symptoms could find utility in these two new scales. Finally, reducing the number of CAPE items could be useful for shorter surveys. Future studies should test the implications of these suggestions.