Abstract
Background: Improving Quality of Life (QoL) in Schizophrenia is an important treatment objective in the shift toward person-centered and recovery-oriented care. Health-Related Quality of Life (HRQoL) is a focused aspect of QoL that is directly impacted by healthcare intervention. This aim of the current study was to ascertain the clinical determinants of HRQoL in Schizophrenia and their collective contribution to HRQoL.Methods: 157 stable outpatients with schizophrenia were recruited for this study. Data collected included sociodemographic information and clinical characteristics. HRQoL was assessed on the RAND-36. Psychopathology was assessed on the Positive and Negative Syndrome Scale (PANSS) and functioning measured on the Global Assessment Scale (GAS).Findings: Multiple regression revealed that the Physical Health Component (PHC) of the RAND-36 was associated with positive symptoms (beta = −0.218, p = 0.005) and presence of psychiatric comorbidity (beta = −0.215, p = 0.003). The Mental Health Component (MHC) was associated with depressive (beta = −0.364, p < 0.001) and positive (beta = −0.175, p = 0.021,) symptoms. Symptoms, functioning, presence of psychiatric comorbidities, gender and age account for 20.3% of the total variance observed in HRQoL.Conclusion: Depressive and positive symptoms are key clinical determinants of HRQoL in people with schizophrenia. However, the medical model—looking solely at clinical determinants—could not account for a large proportion of variance in HRQoL. Hence, future research beyond the medical model is required to uncover the determinants of HRQoL in Schizophrenia. Identifying these factors will contribute toward developing a holistic and person-centered management plan for people with schizophrenia.
Highlights
The interest of Quality of Life (QoL) in Psychiatry grew out of the deinstitutionalization of psychiatric patients into the community and the evaluation of their plight was necessary and relevant [1]
Against the backdrop of recent findings that factors other than clinical or psychopathological domains may play a bigger role in QoL, we aim to examine the collective impact of symptoms, functioning, and clinical variables on the Health-Related QoL (HRQoL) in people with schizophrenia
Even though the effects of depressive symptoms was only seen on the Mental Health Composite (MHC), it is still consistent with the literature as Meijer et al [34] had found that the largest proportion of effect on general quality of life was mediated by the mental health component summary scale of the HRQoL- SF36 measure in their study
Summary
The interest of Quality of Life (QoL) in Psychiatry grew out of the deinstitutionalization of psychiatric patients into the community and the evaluation of their plight was necessary and relevant [1]. There is a general consensus on the characteristics of QoL as oriented toward the patient’s perspective and that it has a subjective and multi-dimensional nature [9] It consists of: “a person’s (a) satisfaction with his/her life as a whole or general wellbeing; (b) observable social and material wellbeing, or objective QoL; (c) satisfaction with his/her social and material well-being, or subjective QoL; and (d) health and functional status, or health-related QoL” [2]p1226. Health-Related Quality of Life (HRQoL) is a focused aspect of QoL that is directly impacted by healthcare intervention.
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