Differences on Quality of Life of Patients with Schizophrenia: A Multicentric Study from Three Latin-America Countries

  • Alejandra Caqueo-Urízar
  • Alfonso Urzúa
  • Koen de Munter
  • María J. Viveros
  • Laurent Boyer
Original Paper


The aim of the study is to explore the variation on patient’s Quality of Life (QoL) across three Latin-Americans countries. The study included 253 stabilized outpatients with schizophrenia from three Mental Health Services in Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Patients’ were assessed using Schizophrenia Quality of Life Questionnaire (SQoL18). We collected socio-demographic information and clinical data, while recognizing the cultural complexity/dynamics of each country, and the influence of cultural contexts on how people experience the health systems. There are differences in QoL according to each country. Peru reports better levels of QoL at the Total Score Index and in most of the dimensions of the SQoL18. Bolivia shows the lowest indicators of QoL, except, interestingly, for the Resilience dimension where it reaches the highest scores. Even when the studied regions in the three Latin American countries share several cultural characteristics, there are also some important differences between them on patients’ QoL. Possible disparities at investment in mental health by the Governments of each country are discussed while possible influences of (inter)cultural contexts are taken into account.


Schizophrenia Quality of life Differences Latin-America 



This research was funded in part by the Universidad de Tarapacá through Proyecto Mayor de Investigación Científica y Tecnológica UTA no. 3732-16.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Awad, A.G., Voruganti, L.N., & Heslegrave, R.J. (1997). Measuring quality of life in patients with schizophrenia. PharmacoEconomics, 11, 32–47.CrossRefGoogle Scholar
  2. Bang, C. 2010 La estrategia de promoción de salud mental comunitaria: Una aproximación conceptual desde el paradigma de la complejidad. Memorias II Congreso Internacional de Investigación y Práctica Profesional en Psicología, Tomo 3. Facultad de Psicología UBA, ed., pp. 242–245. Buenos Aires: Facultad de Psicología UBA. [Links].Google Scholar
  3. Boyer, L., Simeoni, M.C., Loundou, A., D’Amato, T., Reine, G., Lancon, C. et al. (2010). The development of the S-QoL 18: a shortened quality of life questionnaire for patients with schizophrenia. Schizophrenia Research, 121(1-3), 241-250.CrossRefGoogle Scholar
  4. Boyer, L., Baumstarck, K., Boucekine, M., Blanc, J., Lancon, C., & Auquier, P. (2013). Measuring quality of life in patients with schizophrenia: an overview. Expert Review of Pharmacoeconomics & Outcomes Research, 13(3), 343–349.CrossRefGoogle Scholar
  5. Caqueo-Urízar, A., Gutiérrez-Maldonado, J., Ferrer-García, M., Urzúa-Morales, A., & Fernández-Dávila, P. (2013). Typology of schizophrenic symptoms and quality of life in patients and their main caregivers of North of Chile. International Journal of Social Psychiatry, 59(1), 93-100.CrossRefGoogle Scholar
  6. Caqueo-Urízar, A., Boyer, L., Boucekine, M., & Auquier, P. (2014). Spanish cross-cultural adaptation and psychometric properties of the Schizophrenia Quality of Life short-version questionnaire (SQoL18) in 3 middle-income countries: Bolivia, Chile and Peru. Schizophrenia Research, 159(1), 136–143.CrossRefGoogle Scholar
  7. Caqueo-Urízar, A., Breslau, J. & Gilman, S. (2015). Beliefs about the causes of schizophrenia among Aymara and non-Aymara patients and their primary caregivers in the Central-Southern Andes. International Journal of Social Psychiatry, 61(1) 82–91.CrossRefGoogle Scholar
  8. Carreño, A. 2013 Revisiter les frontières et réparer l’histoire.Itinéraires thérapeutiques et processus de sauvegarde de la médecine traditionnelle andine dans un contexte transnational [Revisiting boundaries, recovering history: therapeutic pathways and the process of safeguarding traditional Andean medicine in a transnational framework]. In Anthropologie & Santé.
  9. Cohen, C., Vahia, I., Reyes, P., Diwan, S., Bankole, A., Palekar, N., & Ramirez, P. (2008). Schizophrenia in later life: Clinical symptoms and social well-being. Psychiatric Services, 59, 232–234.CrossRefGoogle Scholar
  10. De Munter, K. 2007 Nayra. Ojos al sur del presente: aproximaciones antropológicas a la interculturalidad contemporánea. Oruro: Latinas Editores-CEPA.Google Scholar
  11. De Munter, K. (2010). Tejiendo reciprocidades: John Murra y el contextualizar entre los aymara contemporáneos. En Chungara. Revista de Antropología Chilena, 42(1), 243-251.Google Scholar
  12. Eack, S., & Newhill, C. (2007). Psychiatric symptoms and quality of life in schizophrenia: A meta-analysis. Schizophrenia Bulletin, 33, 1225–1237.CrossRefGoogle Scholar
  13. Faget-Agius, C., Boyer, L., Jonathan, W., Jean-Philippe, R., Raphaelle, R., Elisabeth, S., Sylviane. C.G., Pascal, A., Maxime, G., & Christophe, L. (2015). Neural substrate of quality of life in patients with schizophrenia: a magnetisation transfer imaging study. Scientific Reports, 5, 17650.CrossRefGoogle Scholar
  14. Fernández Juárez, G. (ed.). Salud e interculturalidad en América Latina. Perspectivas antropológicas. Abya-Yala 2004.Google Scholar
  15. Fernández Juárez, G., ed. 2006a Salud e interculturalidad en América Latina. Antropología de la Salud y Crítica Intercultural. Abya-Yala.Google Scholar
  16. Fernández Juárez, G. 2006b Al hospital van los que mueren”. Desencuentros en salud interucltural en los Andes Bolivianos. En Fernández Juárez, G. (ed.), Salud e interculturalidad en América Latina. Abya-Yala: Antropología de la Salud y Crítica Intercultural.Google Scholar
  17. Gooding, P., Littlewood, D., Owen, R., Johnson, J., & Tarrier, N. (2017). Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours. Journal of Mental Health, [Epub ahead of print].CrossRefGoogle Scholar
  18. Jaen-Varas, D., Silva Ribeiro, W., Whitfield, J. & de Jesus Mari, J. 2014. Mental Health and Psychiatric Care in Bolivia: What Do We Know? Literature Review in International Journal of Mental Health Systems 8(1): 18.CrossRefGoogle Scholar
  19. Johnson, J., Gooding, P.A., Wood, A.M., Taylor, P.J, Pratt, D., & Tarrier, N. (2010). Resilience to suicidal ideation in psychosis: positive self-appraisals buffer the impact of hopelessness. Behaviour Research and Therapy, 48, 883–889.CrossRefGoogle Scholar
  20. Kay, S.R., Fiszbein, A., & Opler, L.A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.CrossRefGoogle Scholar
  21. Kao, Y.C., Liu, Y.P., Chou, M.K., & Cheng, T.H. (2011). Subjective quality of life in patients with chronic schizophrenia: relationships between psychosocial and clinical characteristics. Comprehensive Psychiatry, 52, 171–180.CrossRefGoogle Scholar
  22. Kovess-Masféty, V., Xavier, M., Moreno, Kustner, B., Suchocka, A., Sevilla-Dedieu, C., Dubuis, J., Lacalmontie, E., Pellet, J., Roelandt, J-L., & Walsh, D. (2006). Schizophrenia and quality of life: a one-year follow-up in four EU countries. BMC Psychiatry 6, 39.CrossRefGoogle Scholar
  23. Lazar, Sian (2008). El Alto, Rebel city. Self and Citizenship in Andean Bolivia. Duke University Press, Durham.Google Scholar
  24. Michaux, J. (2004). Hacia un sistema de salud intercultural en Bolivia: de la tolerancia a la necesidad sentida. En Fernández Juárez, G. (ed.). Salud e interculturalidad en América Latina. Perspectivas antropológicas. Abya-Yala.Google Scholar
  25. Mizuno, Y., Wartelsteiner, F., & Frajo-Apor, B. (2016). Resilience research in schizophrenia: A review of recent developments. Current Opinion in Psychiatry, 29, 218–223.CrossRefGoogle Scholar
  26. Mol, A. (2008). The Logic of Care: Health and the Problem of Patient Choice. Londres y Nueva York: Routledge.CrossRefGoogle Scholar
  27. Organización Mundial de la Salud 2013 Estadísticas sanitarias mundiales 2013 [2013 World Health Statistics],
  28. Organización Panamericana de la Salud 2013 WHO-AIMS: Informe Regional sobre los sistemas de salud mental en América Latina y el Caribe [Regional report on systems of mental health in Latin America and the Caribbean]. Oficina Sanitaria Panamericana, Oficina Regional de la Organización Mundial de la Salud,
  29. Peralta, V., & Cuesta, M.J. (1994). Validación de la Escala de los Síndromes Positivo y Negativo (PANSS) en una muestra de esquizofrénicos españoles. [Validation of the positive and negative syndrome scale (PANSS) in a sample of Spanish schizophrenic]. Actas Luso Esp Neurol Psiquiatr Cienc Afines 22(4), 171-7.Google Scholar
  30. Ramírez, S. 2006 La interculturalidad sin todos sus agentes sociales. El problema de la salud intercultural en Bolivia. Fernández Juárez, G. (ed.), Salud e interculturalidad en América Latina. Abya-Yala: Antropología de la Salud y Crítica Intercultural.Google Scholar
  31. Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57, 316–331.CrossRefGoogle Scholar
  32. Van Den Brink, R., Wiersma, D., Wolters, K., Bullenkamp, J., Hansson, L., Lauber, C., et al. (2011). Non-uniform effectiveness of structured patient-clinician communication in community mental healthcare: an international comparison. Social Psychiatry & Psychiatric Epidemiology, 46(8), 685–693.CrossRefGoogle Scholar
  33. Wartelsteiner, F., Mizuno, Y., Frajo-Apor, B., Kemmler, G., Pardeller, S., Sondermann, C., Welte, A., Fleischhacker, W.W., Uchida, H., & Hofer, A. (2016). Quality of life in stabilized patients with schizophrenia is mainly associated with resilience and self-esteem. Acta Psychiatrica Scandinavica, 134, 360–367.CrossRefGoogle Scholar
  34. Winkelman, M. (2008). Culture and Health. Applications from Medical Anthropology. Wiley & Sons.Google Scholar
  35. World Bank 2016 The World Bank Annual Report 2016. Washington, DC. © World Bank, License: CC BY 3.0 IGO.
  36. World Health Organization (1992). ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva. World Health Organization.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Alejandra Caqueo-Urízar
    • 1
  • Alfonso Urzúa
    • 2
  • Koen de Munter
    • 3
  • María J. Viveros
    • 1
  • Laurent Boyer
    • 4
  1. 1.Instituto de Alta InvestigaciónUniversidad de TarapacáAntofagastaChile
  2. 2.Universidad Católica del NorteAntofagastaChile
  3. 3.Departamento de AntropologíaUniversidad Alberto HurtadoSantiagoChile
  4. 4.Aix-Marseille Univ, EA 3279 – Public Health, Chronic Diseases and Quality of Life - Research UnitMarseilleFrance

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