Skip to main content

Advertisement

SpringerLink
Log in

Resilience in severe mental disorders: correlations to clinical measures and quality of life in hospitalized patients with major depression, bipolar disorder, and schizophrenia

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To evaluate resilience in severe mental disorders and correlate it with clinical measures and quality of life.

Methods

Resilience (Resilience Scale, RS) and quality of life (WHOQOL-BREF questionnaire) were prospectively evaluated in a sample of 384 hospitalized patients diagnosed with severe mental disorders (depression, bipolar disorder and schizophrenia). Clinical outcomes were measured using the Global Assessment of Functioning Scale (GAF), Clinical Global Impression (CGI), Cumulative Illness Rating Scale (CIRS), Hamilton Scale-Depression (HAM-D), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS).

Results

Resilience measure showed a difference between the three clinical groups analyzed in the study, with lower scores in depressed patients than in bipolar disorder or schizophrenia patients. There was a trend toward a correlation between resilience and depressive symptoms (Hamilton Scale-Depression; P = 0.052; rs = − 0.163). The scores in the resilience scale's personal competence domain presented a tendency of association with general psychiatric symptoms (Brief Psychiatric Rating Scale; P = 0.058; r = − 0.138). There was a significantly positive association between resilience and all domains of quality of life (r = 0.306–0.545; P < 0.05). Sociodemographic data like age, education, intelligence quotient, sex, and marital status were associated with resilience.

Conclusion

Depressive patients had low scores on the resilience scale compared to patients with other disorders. Resilience was positively associated with quality of life. Therefore, it deserves special attention, as it promotes more positive outcomes and improves patients' quality of life with severe mental disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Walker, F. R., Pfingst, K., Carnevali, L., Sgoifo, A., & Nalivaiko, E. (2015). In the search for integrative biomarker of resilience to psychological stress. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2016.05.003

    Article  Google Scholar 

  2. Griffiths, F. E., Boardman, F. K., Chondros, P., Dowrick, C. F., Densley, K., Hegarty, K. L., et al. (2014). The effect of strategies of personal resilience on depression recovery in an Australian cohort: A mixed methods study. Health (London, England), 19(1), 86–106.

    Article  Google Scholar 

  3. Kesebir, S., Ünübol, B., Tatlıdil Yaylacı, E., Gündoğar, D., & Ünübol, H. (2015). Impact of childhood trauma and affective temperament on resilience in bipolar disorder. International Journal of Bipolar Disorders, 3, 3–7.

    Article  Google Scholar 

  4. Friborg, O., Hjemdal, O., Rosenvinge, J. H., Martinussen, M., Aslaksen, P. M., & Flaten, M. A. (2006). Resilience as a moderator of pain and stress. Journal of Psychosomatic Research, 61(2), 213–219.

    Article  Google Scholar 

  5. Waugh, C. E., & Koster, E. H. W. (2015). A resilience framework for promoting stable remission from depression. Clinical Psychology Review, 41, 49–60. https://doi.org/10.1016/j.cpr.2014.05.004

    Article  PubMed  Google Scholar 

  6. Russo, S. J., Murrough, J. W., Han, M. H., & Charney, D. S. (2012). Neurobiology of resilience. Nature Neuroscience, 15(11), 1475–84.

    Article  CAS  Google Scholar 

  7. Navrady, L. B., Zeng, Y., Clarke, T.-K., Adams, M. J., Howard, D. M., Deary, I. J., et al. (2018). Genetic and environmental contributions to psychological resilience and coping. Wellcome Open Research. https://doi.org/10.12688/wellcomeopenres.13854.1

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hjemdal, O., Aune, T., Reinfjell, T., Stiles, T. C., & Friborg, O. (2007). Resilience as a predictor of depressive symptoms: A correlational study with young adolescents. Clinical Child Psychology and Psychiatry, 12(1), 91–104.

    Article  Google Scholar 

  9. Faye, C., Mcgowan, J. C., Denny, C. A., & David, D. J. (2018). Neurobiological mechanisms of stress resilience and implications for the aged population. Current Neuropharmacology., 16, 234–270.

    Article  CAS  Google Scholar 

  10. Franklin, T. B., Saab, B. J., & Mansuy, I. M. (2012). Neural mechanisms of stress resilience and vulnerability. Neuron, 75(5), 747–761. https://doi.org/10.1016/j.neuron.2012.08.016

    Article  CAS  PubMed  Google Scholar 

  11. Kim-Cohen, J. (2007). Resilience and developmental psychopathology. Child and Adolescent Psychiatric Clinics of North America, 16(2), 271–283.

    Article  Google Scholar 

  12. Elisei, S., Sciarma, T., Verdolini, N., & Anastasi, S. (2013). Resilience and depressive disorders. Psychiatria Danubia, 25(SUPPL.2), 263–7.

    Google Scholar 

  13. Mcgrath, L. M., Cornelis, M. C., Lee, P. H., Robinson, E. B., Duncan, L. E., Barnett, J. H., et al. (2013). Genetic predictors of risk and resilience in psychiatric disorders: A cross-disorder genome-wide association study of functional impairment in major depressive disorder, bipolar disorder, and schizophrenia. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 162(8), 779–788.

    Article  CAS  Google Scholar 

  14. Yoshida, K., Suzuki, T., Imasaka, Y., Kubo, K., Mizuno, Y., Saruta, J., et al. (2016). Resilience in schizophrenia: A comparative study between a remote island and an urban area in Japan. Schizophrenia Research, 171(1–3), 92–6. https://doi.org/10.1016/j.schres.2016.01.030

    Article  PubMed  Google Scholar 

  15. Mizuno, Y., Hofer, A., Suzuki, T., Frajo-Apor, B., Wartelsteiner, F., Kemmler, G., et al. (2016). Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder: A cross-sectional study. Schizophrenia Research, 175(1–3), 148–153. https://doi.org/10.1016/j.schres.2016.04.047

    Article  PubMed  Google Scholar 

  16. Joyce, S., Shand, F., Tighe, J., Laurent, S. J., Bryant, R. A., & Harvey, S. B. (2018). Road to resilience: A systematic review and meta-analysis of resilience training programmes and interventions. British Medical Journal Open, 8(6), 1–9.

    CAS  Google Scholar 

  17. Pakalnieskiene, V., Viliuniene, R., & Hilbig, J. (2016). Patients’ resilience and distress over time: Is resilience a prognostic indicator of treatment? Comprehensive Psychiatry, 69, 88–99.

    Article  Google Scholar 

  18. Liu, H., Zhang, C., Ji, Y., & Yang, L. (2018). Biological and psychological perspectives of resilience: Is it possible to improve stress resistance? Frontiers in Human Neuroscience, 12(August), 1–12.

    Google Scholar 

  19. Haase, J. E., Kintner, E. K., Monahan, P. O., & Robb, S. L. (2014). The resilience in illness model (RIM) part 1: Exploratory evaluation in adolescents and young adults with cancer. Cancer Nursing, 37(3), E1-12.

    Article  Google Scholar 

  20. Newton-John, T., Mason, C., & Hunter, M. (2014). The role of resilience in adjustment and coping with chronic pain. Rehabilitation Psychology, 59(3), 360–365.

    Article  Google Scholar 

  21. de Souza Cotian, M., Vilete, L., Volchan, E., & Figueira, I. (2014). Revisão sistemática dos aspectos psicossociais, neurobiológico, preditores e promotores de resiliência em militares. Jornal Brasileiro de Psiquiatria, 63(1), 72–85.

    Article  Google Scholar 

  22. Elliott, T. R., Yu-Yu, H., Meyer, E. C., DeBeer, B. B., Oi-Man, K., Kimbrel, N. A., et al. (2015). Resilience, traumatic brain injury, depression, and posttraumatic stress among Iraq/Afghanistan war veterans. Rehabilitation Psychology, 60(3), 263–76.

    Article  Google Scholar 

  23. Betancourt, T., Meyers-Ohki, S., Charrow, A., & Hansen, N. (2013). Mental health and resilience in HIV/AIDS affected children: A review of the literature and recommendations for future research. Journal of Child Psychology and Psychiatry, 54(4), 423–444.

    Article  Google Scholar 

  24. Laird, K. T., Krause, B., Funes, C., & Lavretsky, H. (2019). Psychobiological factors of resilience and depression in late life. Translational Psychiatry. https://doi.org/10.1038/s41398-019-0424-7

    Article  PubMed  PubMed Central  Google Scholar 

  25. Arya, D. K. (2013). PRISM: Promoting resilience, independence and self management—A strategy to manage chronic mental illnesses. Asian Journal of Psychiatry, 6(4), 303–307. https://doi.org/10.1016/j.ajp.2013.01.009

    Article  PubMed  Google Scholar 

  26. Nuernberg, G. L., Baeza, F. L., Fleck, M. P., & Rocha, N. S. (2016). Outcomes of inpatients with severe mental illness: A naturalistic descriptive study. Revista Brasileira de Psiquiatria, 38(2), 141–147.

    Article  Google Scholar 

  27. Pesce, R. P., Assis, S. G., Avanci, J. Q., Santos, N. C., Malaquias, J. V., & Carvalhaes, R. (2005). Adaptação transcultural, confiabilidade e validade da escala de resiliência. Cadernos de Saúde Pública, 21(2), 436–448.

    Article  Google Scholar 

  28. Wagner, F., & Trentini, C. M. (2010). Estratégias de avaliação rápida da inteligência através das Escalas Wechsler. Revista Neuropsicologia Latinoamericana, 2(1), 47–54.

    Google Scholar 

  29. Smith, G. N., Ehmann, T. S., Flynn, S. W., MacEwan, G. W., Tee, K., Kopala, L. C., et al. (2011). The assessment of symptom severity and functional impairment with DSM-IV Axis V. Psychiatric Services (Washington, D.C.), 62(4), 411–417.

    Article  Google Scholar 

  30. De Lima, M. S., Soares, B. G. D. O., Paoliello, G., Vieira, R. M., Martins, C. M., Neto, J. I. D. M., et al. (2007). The Portuguese version of the Clinical Global Impression—Schizophrenia Scale: Validation study. Revista Brasileira de Psiquiatria, 29(3), 246–249.

    Article  Google Scholar 

  31. Vilela, J. A. A., Crippa, J. A. S., Del-Ben, C. M., & Loureiro, S. R. (2005). Reliability and validity of a Portuguese version of the Young Mania Rating Scale. Brazilian Journal of Medical and Biological Research, 38(9), 1429–1439.

    Article  CAS  Google Scholar 

  32. Carneiro, A. M., Fernandes, F., & Moreno, R. A. (2015). Hamilton depression rating scale and montgomery-asberg depression rating scale in depressed and bipolar I patients: Psychometric properties in a Brazilian sample. Health and Quality of Life Outcomes. https://doi.org/10.1186/s12955-015-0235-3

    Article  PubMed  PubMed Central  Google Scholar 

  33. Crippa, J. A. S., Sanches, R. F., Hallak, J. E. C., Loureiro, S. R., & Zuardi, A. W. (2002). Factor structure of Bech’s version of the Brief Psychiatric Rating Scale in Brazilian patients. Brazilian Journal of Medical and Biological Research, 35(10), 1209–1213.

    Article  CAS  Google Scholar 

  34. Miller, M. D., Paradis, C. F., Houck, P. R., Mazumdar, S., Stack, J. A., Rifai, A. H., et al. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Research, 41(3), 237–248.

    Article  CAS  Google Scholar 

  35. Zhu, Y., Womer, F. Y., Leng, H., Chang, M., Yin, Z., Wei, Y., et al. (2019). The relationship between cognitive dysfunction and symptom dimensions across schizophrenia, bipolar disorder, and major depressive disorder. Frontiers in Psychiatry, 10(April), 1–8.

    Google Scholar 

  36. Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1(2), 165–178.

    CAS  PubMed  Google Scholar 

  37. Fleck, M. P., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., et al. (2000). Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Revista de Saude Publica, 34(2), 178–183.

    Article  CAS  Google Scholar 

  38. Rocha, N. S., Power, M. J., Bushnell, D. M., & Fleck, M. P. (2012). Cross-cultural evaluation of the WHOQOL-BREF domains in primary care depressed patients using Rasch Analysis. Medical Decision Making, 32(1), 41–55.

    Article  Google Scholar 

  39. Mosqueiro, B. P., Da Rocha, N. S., & Fleck, M. P. D. A. (2015). Intrinsic religiosity, resilience, quality of life, and suicide risk in depressed inpatients. Journal of Affective Disorders, 179, 128–133. https://doi.org/10.1016/j.jad.2015.03.022

    Article  PubMed  Google Scholar 

  40. da Rocha, N. S., Power, M. J., Bushnell, D. M., & Fleck, M. P. (2009). Is there a measurement overlap between depressive symptoms and quality of life? Comprehensive Psychiatry, 50(6), 549–555. https://doi.org/10.1016/j.comppsych.2008.11.015

    Article  PubMed  Google Scholar 

  41. Mak, W. W. S., Ng, I. S. W., & Wong, C. C. Y. (2011). Resilience: Enhancing well-being through the positive cognitive triad. Journal of Counseling Psychology, 58(4), 610–617.

    Article  Google Scholar 

  42. Rutten, B. P. F., Hammels, C., Geschwind, N., Menne-Lothmann, C., Pishva, E., Schruers, K., et al. (2013). resilience in mental health: Linking psychological and neurobiological perspectives. Acta Psychiatrica Scandinavica, 128(1), 3–20.

    Article  CAS  Google Scholar 

  43. Toyoshima, K., Kako, Y., Toyomaki, A., Shimizu, Y., Tanaka, T., Nakagawa, S., Inoue, T., Martinez-Aran, A., Vieta, E., & Kusumi, I. (2019). Associations between cognitive impairment and quality of life in euthymic bipolar patients. Psychiatry Research, 271, 510–515.

    Article  Google Scholar 

  44. Toyoshima, K., Inoue, T., Masuya, J., Ichiki, M., Fujimura, Y., & Kusumi, I. (2019). Evaluation of subjective cognitive function using the cognitive complaints in bipolar disorder rating assessment (COBRA) in Japanese adults. Neuropsychiatric Disease and Treatment, 15, 2981–2990.

    Article  Google Scholar 

  45. Fiszdon, J. M., Roberts, D. L., Penn, D. L., Choi, K.-H., Tek, C., Choi, J., et al. (2017). Understanding Social Situations (USS): A proof-of-concept social–cognitive intervention targeting theory of mind and attributional bias in individuals with psychosis. Psychiatric Rehabilitation Journal, 40, 12–20.

    Article  Google Scholar 

  46. Kukla, M., Lysaker, P. H., & Roe, D. (2014). Strong subjective recovery as a protective factor against the effects of positive symptoms on quality of life outcomes in schizophrenia. Comprehensive Psychiatry, 55(6), 1363–1368. https://doi.org/10.1016/j.comppsych.2014.04.022

    Article  PubMed  Google Scholar 

  47. Seok, J.-H., Lee, K.-U., Kim, W., Lee, S.-H., Kang, E.-H., Ham, B.-J., et al. (2012). Impact of early-life stress and resilience on patients with major depressive disorder. Yonsei Medical Journal, 53(6), 1093.

    Article  Google Scholar 

  48. Campbell-Sills, L., Cohan, S. L., & Stein, M. B. (2006). Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behaviour Research and Therapy, 44(4), 585–599.

    Article  Google Scholar 

Download references

Funding

Hospital de Clínicas de Porto Alegre Research Incentive Fund (FIPE). Fundação de Amparo à Pesquisa do RS—19/251-0001930-0. Conselho Nacional de Desenvolvimento Científico e Tecnológico- 303652/2019-5. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Author information

Authors and Affiliations

  1. Graduation Program in Psychiatry and Behavior Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Katiúscia Gomes Nunes & Neusa Sica da Rocha

  2. Center of Clinical Research, Center of Experimental Research, and Psychiatric Service Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil

    Katiúscia Gomes Nunes & Neusa Sica da Rocha

  3. I-QOL: Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil

    Katiúscia Gomes Nunes & Neusa Sica da Rocha

  4. Porto Alegre, Brazil

    Katiúscia Gomes Nunes

Authors
  1. Katiúscia Gomes Nunes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Neusa Sica da Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katiúscia Gomes Nunes.

Ethics declarations

Conflict of interest

The authors declares that there is no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nunes, K.G., da Rocha, N.S. Resilience in severe mental disorders: correlations to clinical measures and quality of life in hospitalized patients with major depression, bipolar disorder, and schizophrenia. Qual Life Res 31, 507–516 (2022). https://doi.org/10.1007/s11136-021-02920-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-021-02920-3

Keywords

Search

Navigation