Determinants of Health-Related Quality of Life in Schizophrenia: Beyond the Medical Model

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.

Do Negative Emotional States Play a Role in the Association Between Intimate Partner Violence and Poor Health-Related Quality of Life in Chinese Women From Low-Income Families?

“…For example, a recent study conducted in Hong Kong found that depressive, anxiety, and stress symptoms mediated the association between IPV and reduced HRQoL in a sample of college students (Choi et al, 2017). This finding is in line with other studies, where MH was found to adversely affect HRQoL in patients with schizophrenia (Lim & Lee, 2018), beta-thalassemia major (Adib-Hajbaghery et al, 2015), and kidney disease (Perales Montilla et al, 2016).…”

Cardiovascular Disease Risk and Health-Related Quality of Life among People with Serious Mental Illness in Supportive Housing

“…To our knowledge, this is the rst study to examine the combined impact of CVD risk on HRQoL among people with SMI and ndings are consistent with research available on general population samples [25]. Despite the high rates of CVD risk and medical co-morbidities of persons with SMI, inclusion of these factors in studies of determinants of HRQoL within this population is rare [48]. Consistent screening of persons with SMI, particularly those living in supportive housing, would help to identify those with clustering of multiple risk factors for CVD, who could represent high priority for intervention and risk management.…”

Factors that Change the Quality of Life of Patients with Schizophrenia: A Systematic Review

“…Also according to the results found by Lim and Lee (2018), the positive symptoms cause an impaired HRQoL in physical and emotional domains. Many studies fail to establish statistical relevance between psychotic symptoms and HRQoL, it because of the low sensitivity of generic scales for this type of symptom; and the fact that studies are often conducted in hospitals, where the patients evaluated are under the medication effect.…”

“…The research conducted by Domenech, Altamura et al (2018) corroborates these findings, for them, the main cause would be the decrease in social relations and, therefore, this could be one of the improvement targets for this population. Lim and Lee (2018) found that depressive symptoms are also linked to social isolation and self-report dissatisfaction and therefore impact more significantly the HRQOL.…”