Investigating Health Related Quality of Life in People with Schizophrenia

Indiana University-Purdue University Indianapolis (IUPUI)Schizophrenia is a serious mental illness that significantly lessens health-related quality of life (HRQoL). A better understanding of HRQoL is needed to inform holistic and patient-centered treatments for schizophrenia. The purpose of this dissertation is to conduct an in-depth exploration of HRQoL in people with schizophrenia. The dissertation includes three components. The first component is an integrative literature review aimed at identifying factors associated with physical quality of life (QoL) in people with schizophrenia. The review reveals that symptoms of schizophrenia, depression, obesity or body mass index, and physical activity are associated with physical QoL in this population. The second and third components are based on illness narratives of 20 people with schizophrenia who had participated in a larger study of individuals diagnosed with serious mental illness. The second component of the dissertation is a qualitative descriptive study conducted to describe common HRQoL concerns in people with schizophrenia. The results indicate that these concerns were related to social relationships, psychiatric symptoms, psychiatric care, and employment. The third component of the dissertation is a parallel convergent mixed-methods study conducted to explore whether computerized lexical analysis (CLA) of illness narratives of people with schizophrenia can reveal their HRQoL concerns. CLA is an automatized process that counts words in text data and sorts them into pre-defined word categories. The results provide preliminary support for the potential use of CLA to efficiently assess HRQoL in people with schizophrenia as the CLA identified some of the HRQoL concerns that had been identified in the prior qualitative descriptive study. The results of the three studies reveal the complexity of the phenomenon of HRQoL in people with schizophrenia and can inform the development of strategies to identify and promote HRQoL in this population

A Subset of Type I Conventional Dendritic Cells Controls Cutaneous Bacterial Infections through VEGF alpha-Mediated Recruitment of Neutrophils

Skin conventional dendritic cells (cDCs) exist as two distinct subsets, cDC1s and cDC2s, which maintain the balance of immunity to pathogens and tolerance to self and microbiota. Here, we examined the roles of dermal cDC1s and cDC2s during bacterial infection, notably Propionibacterium acnes (P. acnes). cDC1s, but not cDC2s, regulated the magnitude of the immune response to P. acnes in the murine dermis by controlling neutrophil recruitment to the inflamed site and survival and function therein. Single-cell mRNA sequencing revealed that this regulation relied on secretion of the cytokine vascular endothelial growth factor alpha (VEGF-alpha) by a minor subset of activated EpCAM(+)CD59(+) Ly-6D(+) cDC1s. Neutrophil recruitment by dermal cDC1s was also observed during S. aureus, bacillus Calmette-Guerin (BCG), or E. coli infection, as well as in a model of bacterial insult in human skin. Thus, skin cDC1s are essential regulators of the innate response in cutaneous immunity and have roles beyond classical antigen presentation