The importance of social comparisons for high levels of subjective quality of life in chronic schizophrenic patients.
ABSTRACT In schizophrenic patients, quality of life (QoL) studies often find high levels of general life satisfaction and satisfaction in various life domains despite deprived living conditions. Therefore, the usefulness of QoL as an outcome indicator has been questioned. Since social comparison processes have been postulated to be related to the level of satisfaction, this hypothesis was analysed empirically by the present study in schizophrenic patients. Satisfaction and social comparisons of 148 schizophrenic inpatients and 66 mentally healthy controls were examined with regard to the domains 'health' and 'family' by means of a standardised interview. The schizophrenic patients had a history of either long-term (n = 75) or short-term (n = 73) restricted and deprived living conditions. Long-term patients showed significantly higher satisfaction levels than short-term patients. They compared themselves predominantly laterally or downwards with fellow inpatients. Significant relationships between the direction of social comparisons and satisfaction ratings were found in all three samples. Social comparisons proved to be important for the level of satisfaction in schizophrenic patients. Results indicate that experiences of restricted and deprived living conditions induce accommodation processes and response-shifts that should be taken into account in the interpretation of quality-of-life data.
Article: Longitudinal assessment of coping abilities at exacerbation and stabilization in schizophrenia.[show abstract] [hide abstract]
ABSTRACT: Coping strategies play an important role in one's ability to adapt to stressful life conditions such as schizophrenia. To better understand the nature of various coping mechanisms at various stages in schizophrenia, this study examined task-, emotion-, and avoidance-oriented coping strategies and explored associated clinical factors at exacerbation and stabilization phases of the illness. Patients with schizophrenia were examined twice (at exacerbation phase, N = 237 and at stabilization phase, N = 148) with the Coping Inventory for Stressful Situations, and standardized measures of psychopathology and emotional distress severity, side effects, insight, self-constructs, social support, and quality of life. Multiple regression analysis was performed with coping strategies as dependent variables at exacerbation and stabilization including analysis of any change during the 16-month follow-up period. Analysis indicated that emotion coping strategies were used more at exacerbation than at stabilization phase. Regression analysis demonstrated emotional distress to be a strong predictor of emotion-oriented coping, with self-efficacy and social support being the best predictors of task and avoidance coping strategies, respectively. Individual changes in these variables also appear to be important predictors for fluctuations of these coping strategies over time. Severity of symptoms accounted for 3.5% and 5.5% to 9% of the total variance of emotion- and task-oriented coping strategies, respectively. Emotion, task, and avoidance coping strategies and their predictors are influenced and may vary over the course of schizophrenia illness. Experienced emotional distress, self-efficacy, and social support are the best predictors of coping strategies both at exacerbation and stabilization phases of illness.Comprehensive Psychiatry 46(3):167-75. · 2.26 Impact Factor
Article: A community study of the health-related quality of life of schizophrenia and general practice outpatients in Singapore.[show abstract] [hide abstract]
ABSTRACT: Health-related quality of life (HRQOL) is an important outcome indicator of healthcare that has been little studied in East Asia, where, culturally, there is greater family interdependence than in the West. We aimed to study the HRQOL of schizophrenia outpatients compared to general practice outpatients, and to examine determinants of schizophrenia HRQOL in our community. The HRQOL of 94 schizophrenia and 90 general practice outpatients was assessed using the COOP/WONCA chart. Clinical status, demographics, medication dosages, extrapyramidal side-effects, and frequency of personal, family and social functioning were assessed using standardized questionnaires. Some 90% of schizophrenia outpatients still lived with their immediate families, and the majority were single, unemployed, and rarely engaged in social activities. They had poorer satisfaction with overall HRQOL compared to general practice outpatients. Using stepwise linear regression analysis, poorer schizophrenia overall HRQOL was predicted by dissatisfaction with and poorer participation in family relationships, dissatisfaction with emotional well-being and male gender [R(2) = 0.40, p = 0.040; F(4, 5.1) = 14.3, p < 0.001]. Strained family relationships appeared to be an important contributor to poorer schizophrenia HRQOL in our East Asian community. This could possibly be related to the narrowing of social-occupational functioning and its burden on the family.Social Psychiatry and Psychiatric Epidemiology 02/2004; 39(2):106-12. · 2.70 Impact Factor