Quality of Life and Its Determinants in Patients with Schizophrenia Attending a Psychiatric Outpatient Service: A Cross-Sectional Study Using WHOQOL-BREF and PANSS at a Tertiary Care Hospital in India
DOI:
https://doi.org/10.48047/z0m1kc21Keywords:
Schizophrenia,, Quality of life,, PANSS, Negative symptoms, Family support,, RecoveryAbstract
Background: Quality of life (QoL) is a multidimensional outcome in schizophrenia that extends beyond symptom remission, encompassing subjective well-being, social functioning, and participation. Despite accumulating pharmacological advances, QoL in people with schizophrenia remains substantially impaired compared to the general population. This study assessed QoL using the WHOQOL-BREF instrument and identified its clinical and psychosocial determinants in a cohort of stable outpatients with schizophrenia in India. Methods: Cross-sectional study of 150 outpatients with ICD-10 schizophrenia (stable, no acute relapse in past 3 months) attending a tertiary psychiatry clinic. QoL was measured using the WHOQOL-BREF (four domains: Physical Health, Psychological, Social Relationships, Environment). Symptom severity was assessed by PANSS; depressive symptoms by Calgary Depression Scale (CDSS); family support by a structured scale. Multivariable linear regression identified determinants of overall QoL. Results: All four WHOQOL-BREF domain scores were significantly lower than Indian community reference values (all p<0.001): Physical 52 vs 68, Psychological 47 vs 64, Social Relationships 44 vs 62, Environment 51 vs 65. Mean overall QoL composite was 48.5 ± 14.8. Independent predictors (multivariable linear regression): PANSS-Negative ≥21 (β=−9.1), depressive symptoms CDSS ≥6 (β=−7.4), poor family support (β=−6.5), unemployment (β=−5.8), illness duration >10 years (β=−6.2), and atypical antipsychotic use (β=+4.2). Conclusion: Schizophrenia is associated with globally impaired QoL across all domains relative to Indian community norms. Negative symptoms, depressive symptoms, poor family support, and unemployment are the strongest modifiable determinants. Rehabilitation programmes targeting employment, family psychoeducation, clozapine/atypical antipsychotic optimisation, and treatment of depressive symptoms should be central to recovery-oriented care.
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