Differences in Quality of Life Domains and Psychopathologic and Psychosocial Factors in Psychiatric Patients.

Background: Although treatment of severe mentaldisorders should strive to optimize quality of life (QOL) for theindividual patient, little is known about variations in QOLdomains and related psychopathologic and psychosocial factors inpatients suffering from schizophrenia, schizoaffective disorder,and/or mood disorders. We hypothesized that QOL in severe mentaldisorder patients would have a more substantial relationship withpsychosocial factors than with illness-associated factors.

Method: A case-control, cross-sectional designwas used to examine QOL of 210 inpatients who met DSM-IV criteriafor a severe mental disorder and who were consecutively admittedto closed, open, and rehabilitation wards. Following psychiatricexamination, 210 inpatients were assessed using standardizedself-report measures of QOL, insight, medication side effects,psychological distress, self-esteem, self-efficacy, coping,expressed emotion, and social support. QOL ratings for patientsand a matched control group (175 nonpatients) were compared.Regression and factor analyses were used to comparemultidimensional variables between patients with schizophreniaand schizoaffective and mood disorders.

Results: In all QOL domains, patients were lesssatisfied than nonpatient controls. Patients with schizophreniareported less satisfaction with social relationships andmedication when compared with patients with schizoaffectiveand/or mood disorders. Regression analysis establisheddifferential clusters of predictors for each group of patientsand for various domains of QOL. On the basis of the results offactor analysis, we propose a distress protection model toenhance life satisfaction for severe mental disorder patients.

Conclusion: Psychosocial factors rather thanpsychopathologic symptoms affect subjective QOL of hospitalizedpatients with severe mental disorders. The findings enable betterunderstanding of the combining effects of psychopathology andpsychosocial factors on subjective life satisfaction andhighlight targets for more effective intervention andrehabilitation.