Ten-year quality of life outcomes among patients with schizophrenia and schizoaffective disorder II. Predictive value of psychosocial factors

Purpose To identify psychosocial predictors of change in health-related quality of life among patients with schizophrenia (SZ) and schizoaffective (SA) disorders over a 10-year period. Methods In a naturalistic longitudinal design, 108 patients with SZ/SA disorders completed a comprehensive rating scale battery including self-reported quality of life, emotional distress symptoms, coping styles, sense of self-efficacy, and social support, as well as observer-rated psychopathology, medication side effects, and general functioning at 2 time points, baseline and 10 years later. Results Regression models revealed that reduction in self-reported symptoms of depression, sensitivity or anxiety along with increase in self-efficacy, social support, and emotion-oriented coping scores predicted improvement in domain-specific perceived quality of life. Adjustment of the psychosocial models for the effects of disorder-related factors (psychopathology, functioning, and medication side effects) confirmed the above findings and amplified their statistical power. Conclusions In the long-term course of severe mental disorders (SZ/SA), changes in the psychosocial factors are stronger predictors of subjective quality of life outcome than disorder-related changes. The findings enable better understanding of the combined effects of psychopathology and psychosocial factors on quality of life outcome over a 10-year period.