A cross-sectional observational study to estimate the psychosocial adjustment in patients with schizophrenia

Abstract

Context: Psychosocial dysfunction is the dysfunction in the various psychosocial areas, such as personal, vocational/occupational, familial, and social, which ultimately depends on the cognitive functioning of an individual. Any disturbances and failure to adjust in one or more areas have a sufficient impact on the patient’s quality of life and daily living. For everyday living and maintaining a good quality of life, the influence of the level of dysfunction in different areas needs to be understood, and psychosocial interventions and rehabilitation programs must be designed accordingly to facilitate better psychosocial adjustment. Aims: The aim of this study was to estimate the psychosocial adjustment of individuals with Schizophrenia presenting at the psychiatry outpatient department (OPD) of a teaching hospital. Materials and Methods A cross-sectional study was conducted at the psychiatry OPD of a tertiary care teaching hospital. Eligible subjects were aged between 18 and 65 years and diagnosed with Schizophrenia according to the International Classification of Diseases-10. Sociodemographic characteristics and current treatment details were obtained. The psychosocial adjustment was assessed using the Psychosocial Adjustment to Illness Scale-interview version. Results: Sixty subjects were included, all with some impairment in one or the other social functioning domain. The domain with the highest proportion of subjects showing marked/severe degrees of disability is the vocational environment. Moderate-to-severe impairment of functioning is seen in the domains of domestic environment, social environment, sexual relationship, and extended family relationships. In the health-care environment, mild impairment is seen among most subjects. Only mild psychological distress was found among those with impaired functioning in this domain. It was also found that individuals with mild adjustment problems had a shorter duration of illness. Variables that showed significant statistical associations (P < 0.05) with poor/severe social adjustment were marital status and duration of illness. Age and Gender had a statistically significant association with psychosocial dysfunction in the social environment domain. Conclusion: This study shows that there is definite and substantial psychosocial dysfunction in definitive areas of personal, familial, social, and vocational spheres in patients with schizophrenia. Psychosocial interventions, along with antipsychotics, are needed to target these areas to improve the overall quality of life of patients with schizophrenia.