Abstract
Many studies have demonstrated that quality of life (QoL) is poor among individuals suffering from severe mental illness like bipolar disorder (BD) and Schizophrenia due to various factors like residual symptoms, side effects of medication, and lack of social support. This study aims to explore the relationship between QoL and perceived social support among patients with schizophrenia and BD in remission and to identify the factors associated with QoL. A cross-sectional, descriptive study was carried out in a Psychiatry outpatient department of a tertiary care hospital. Patients diagnosed with BPAD and Schizophrenia as per International Classification Disorders-10 diagnostic criteria were recruited for the study. The WHO Quality of Life BREF Scale was used to assess quality of life and the Multidimensional Scale of Perceived Social Support was used to assess social support. The mean age of Schizophrenia and the BD group was 35.86 years (± 11.40) and 38.34 years (± 11.10). In the quality of life domain, patients with schizophrenia had significantly high environmental health as compared to the bipolar group. More than one-half of patients with Schizophrenia and three-fifth of patients with BD perceived high support. The perceived support was found to be more from the family followed by friends and significant others. There was a significant positive correlation between social support and quality of life in patients with Schizophrenia only. Hence, psychosocial interventions aimed at improving social support needs to promoted in routine patient care
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References
Adelufosi AO, Adebowale TO, Abayomi O, Mosanya JT. Medication adherence and quality of life among Nigerian outpatients with schizophrenia. Gen Hosp Psychiatr. 2012;34(1):72–9.
Altman S, Haeri S, Cohen LJ, Ten A, Barron E, Galynker II, Duhamel KN. Predictors of relapse in bipolar disorder: a review. J Psychiatr Pract. 2006;12(5):269–82. https://doi.org/10.1097/00131746-200609000-00002.
American Psychiatric Association. (2000) Global Assessment of Functioning scale. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Text Revision. (p34). Washington, DC: American Psychiatric Association.
Bengtsson-Tops A, Hansson L. Quantitative and qualitative aspects of the social network in schizophrenic patients living in the community. Relationship to sociodemographic characteristics and clinical factors and subjective quality of life. Int J Soc Psychiatr. 2001;47(3):67–77.
Beyer JL, Kuchibhatla M, Looney C, Engstrom E, Cassidy F, Krishnan KR. Social support in elderly patients with bipolar disorder. Bipolar Disord. 2003;5(1):22–7. https://doi.org/10.1034/j.1399-5618.2003.00016.x.
Brissos S, Dias VV, Carita AI, Martinez-Arán A. Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates. Psychiatr Res. 2008;160(1):55–62. https://doi.org/10.1016/j.psychres.2007.04.010.
Chand PK, Mattoo SK, Sharan P. Quality of life and its correlates in patients with bipolar disorder stabilized on lithium prophylaxis. Psychiatr Clin Neurosci. 2004;58:311–8. https://doi.org/10.1111/j.1440-1819.2004.01237.x.
Cohen AN, Hammen C, Henry RM, Daley SE. Effects of stress and social support on recurrence in bipolar disorder. J Affect Disord. 2004;82(1):143–7. https://doi.org/10.1016/j.jad.2003.10.008.
Cohen S, McKay G. Social support, stress, and the buffering hypothesis: A theoretical analysis. In: Baum A, Singer JE, Taylor SE, editors. Handbook of psychology and health. Hillsdale NJ: Erlbaum; 1984. p. 253–67.
Corrigan PW, Phelan SM. Social support and recovery in people with serious mental illnesses. Commun Ment Health J. 2004;40(6):513–23. https://doi.org/10.1007/s10597-004-6125-5.
Dahlan R, Midin M, Shah SA, Nik Jaafar NR, Abdul Rahman FN, Baharudin A, Das S, Sidi H. Functional remission and employment among patients with schizophrenia in Malaysia. Compr Psychiatr. 2014;55(Suppl 1):46–51. https://doi.org/10.1016/j.comppsych.2013.03.007.
Degnan A, Berry K, Sweet D, Abel K, Crossley N, Edge D. Social networks and symptomatic and functional outcomes in schizophrenia: a systematic review and meta-analysis. Soc Psychiatr Psychiatr Epidemiol. 2018;53(9):873–88. https://doi.org/10.1007/s00127-018-1552-8.
Dorz S, Borgherini G, Conforti D, Scarso C, Magni G. Depression in inpatients: bipolar vs unipolar. Psychol Rep. 2003;92(3):1031–9. https://doi.org/10.2466/pr0.2003.92.3.1031.
Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007;33(5):1225–37. https://doi.org/10.1093/schbul/sbl071.
Eidelman P, Gershon A, Kaplan K, McGlinchey E, Harvey AG. Social support and social strain in inter-episode bipolar disorder. Bipolar Disord. 2012;14(6):628–40. https://doi.org/10.1111/j.1399-5618.2012.01049.x.
Greenberg S, Rosenblum KL, McInnis MG, Muzik M. The role of social relationships in bipolar disorder: a review. Psychiatry Res. 2014;219(2):248–54. https://doi.org/10.1016/j.psychres.2014.05.047.
Hamaideh S, Al-Magaireh D, Abu-Farsakh B, Al-Omari H. Quality of life, social support, and severity of psychiatric symptoms in Jordanian patients with schizophrenia. J Psychiatr Ment Health Nurs. 2014;21(5):455–65. https://doi.org/10.1111/jpm.12112.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62. https://doi.org/10.1136/jnnp.23.1.56.
Hansson L. Determinants of quality of life in people with severe mental illness. Acta Psychiatr Scand Suppl. 2006;429:46–50. https://doi.org/10.1111/j.1600-0447.2005.00717.x.
Hofer A, Mizuno Y, Wartelsteiner F, Wolfgang Fleischhacker W, Frajo-Apor B, Kemmler G, Mimura M, Pardeller S, Sondermann C, Suzuki T, Welte A, Uchida H. Quality of life in schizophrenia and bipolar disorder: the impact of symptomatic remission and resilience. Europ Psychiatr: Journal Assoc Europ Psychiatr. 2017;46:42–7. https://doi.org/10.1016/j.eurpsy.2017.08.005.
Johnson L, Lundström O, Aberg-Wistedt A, Mathé AA. Social support in bipolar disorder: its relevance to remission and relapse. Bipolar Disord. 2003;5(2):129–37. https://doi.org/10.1034/j.1399-5618.2003.00021.x.
Johnson SL, Winett CA, Meyer B, Greenhouse WJ, Miller I. Social support and the course of bipolar disorder. J Abnorm Psychol. 1999;108(4):558–66. https://doi.org/10.1037//0021-843x.108.4.558.
Kizilkurt OK, Giynas FE, Gulec MY, Gulec H. Bipolar disorder and perceived social support: relation with clinical course, and the role of suicidal behaviour. Psychiatr Clin Psychopharmacol. 2019;29(4):787–93. https://doi.org/10.1080/24750573.2019.1639410.
Kleindienst N, Engel RR, Greil W. Psychosocial and demographic factors associated with response to prophylactic lithium: a systematic review for bipolar disorders. Psychol Med. 2005;35(12):1685–94. https://doi.org/10.1017/S0033291705004484.
Kulhara P, Basu D, Mattoo SK, Sharan P, Chopra R. Lithium prophylaxis of recurrent bipolar affective disorder: long-term outcome and its psychosocial correlates. J Affect Disord. 1999;54(1–2):87–96. https://doi.org/10.1016/s0165-0327(98)00145-1.
Kulhara P, Chakrabarti S. Culture and schizophrenia and other psychotic disorders. Psychiatr Clin North Am. 2001;24(3):449–64. https://doi.org/10.1016/s0193-953x(05)70240-9.
Lambert M, Naber D. Current issues in schizophrenia: overview of patient acceptability, functioning capacity and quality of life. CNS Drugs. 2004;18(Suppl 2):5–43. https://doi.org/10.2165/00023210-200418002-00002.
Lipton FR, Cohen CI, Fischer E, Katz SE. Schizophrenia: a network crisis. Schizophr Bull. 1981;7(1):144–51. https://doi.org/10.1093/schbul/7.1.144.
Macdonald EM, Hayes RL, Baglioni AJ Jr. The quantity and quality of the social networks of young people with early psychosis compared with closely matched controls. Schizophr Res. 2000;46(1):25–30. https://doi.org/10.1016/s0920-9964(00)00024-4.
Mahmoud AS, Berma AE, Gabal SAAS. Relationship between social support and the quality of life among psychiatric Patients. Port Said Sci J Nurs. 2017;4:182–201.
Mehta UM, Thirthalli J, Naveen Kumar C, Keshav Kumar J, Keshavan MS, Gangadhar BN. Schizophrenia patients experience substantial social cognition deficits across multiple domains in remission. Asian J Psychiatr. 2013;6(4):324–9. https://doi.org/10.1016/j.ajp.2013.02.001.
Munikanan T, Midin M, Daud T, Rahim RA, Bakar A, Jaafar N, Sidi H, Baharuddin N. Association of social support and quality of life among people with schizophrenia receiving community psychiatric service: a cross-sectional study. Compr Psychiatr. 2017;75:94–102. https://doi.org/10.1016/j.comppsych.2017.02.009.
Rabinovitch M, Cassidy C, Schmitz N, Joober R, Malla A. The influence of perceived social support on medication adherence in first-episode psychosis. Can J Psychiatr Revue Canadienne de Psychiatrie. 2013;58(1):59–65. https://doi.org/10.1177/070674371305800111.
Raj EA, Shiri S, Jangam KV. Subjective burden, psychological distress, and perceived social support among caregivers of persons with schizophrenia. Indian Journal of Social Psychiatry. 2016;32:42–9.
Rüesch P, Graf J, Meyer PC, Rössler W, Hell D. Occupation, social support and quality of life in persons with schizophrenic or affective disorders. Soc Psychiatr Psychiatr Epidemiol. 2004;39(9):686–94. https://doi.org/10.1007/s00127-004-0812-y.
Sawant NS, Jethwani KS. Understanding family functioning and social support in unremitting schizophrenia: A study in India. Indian journal of psychiatry. 2010;52(2):145–9. https://doi.org/10.4103/0019-5545.64593.
Skevington SM, Lotfy M. O’Connell KA The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial A report from the WHOQOL group. Quality of life Research. 2004;13(2):299–310.
Studart PM, Bezerra Filho S, Studart ABD, Almeida AGD, Miranda-Scippa Â. Social support and bipolar disorder. Archiv Clin Psychiatr. 2015;42:95–9.
Tempier R, Balbuena L, Lepnurm M, Craig TK. Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis. Soc Psychiatr Psychiatr Epidemiol. 2013;48(12):1897–904. https://doi.org/10.1007/s00127-013-0701-3.
Tompson MC, Goldstein MJ, Lebell MB, Mintz LI, Marder SR, Mintz J. Schizophrenic patients’ perceptions of their relatives’ attitudes. Psychiatr Res. 1995;57(2):155–67. https://doi.org/10.1016/0165-1781(95)02598-q.
Vázquez Morejón AJ, León Rubio JM, Vázquez-Morejón R. Social support and clinical and functional outcome in people with schizophrenia. Int J Soc Psychiatr. 2018;64(5):488–96. https://doi.org/10.1177/0020764018778868.
Weinstock LM, Miller IW. Psychosocial predictors of mood symptoms 1 year after acute phase treatment of bipolar I disorder. Compr Psychiatr. 2010;51(5):497–503. https://doi.org/10.1016/j.comppsych.2010.02.001.
World Health Organization (WHO) (2016) Process of translation and adaptation of instruments. http://www.who.int/substance_abuse/research_tools/translation/en/. Accessed on 11 September 2020.
Yen CF, Cheng CP, Huang CF, Yen JY, Ko CH, Chen CS. Quality of life and its association with insight, adverse effects of medication and use of atypical antipsychotics in patients with bipolar disorder and schizophrenia in remission. Bipolar Disord. 2008;10:617–24.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatr: J Mental Sci. 1978;133:429–35. https://doi.org/10.1192/bjp.133.5.429.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41. https://doi.org/10.1207/s15327752jpa5201_2.
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SP: concepts, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review; PD: concepts, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review, guarantor; NV: concepts, design, definition of intellectual content, literature search, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review; VM: concepts, design, definition of intellectual content, literature search, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review.
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Prabhakaran, S., Nagarajan, P., Varadharajan, N. et al. Relationship Between Quality of Life and Social Support Among Patients with Schizophrenia and Bipolar Disorder: A Cross-Sectional Study. J. Psychosoc. Rehabil. Ment. Health 8, 137–145 (2021). https://doi.org/10.1007/s40737-020-00211-7
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DOI: https://doi.org/10.1007/s40737-020-00211-7