Academic journal article Hong Kong Journal of Psychiatry

The Comparison of Quality of Life among Patients with Schizophrenia and Major Mood Disorder in Remission in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur

Academic journal article Hong Kong Journal of Psychiatry

The Comparison of Quality of Life among Patients with Schizophrenia and Major Mood Disorder in Remission in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur

Article excerpt

Abstract

Objective: To examine quality of life in relation to demographic profiles and clinical factors in patients with schizophrenia and major mood disorder in remission.

Participants and Methods: This was a cross-sectional study conducted in the outpatient psychiatric clinic at the Hospital Universiti Kebangsaan Malaysia from June 2002 to December 2002. All the patients fulfilled the study inclusion criteria. Their psychiatric diagnoses were made by their treating psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition). The remission state was determined using the Brief Psychiatric Rating Scale, 17-item Hamilton Depression Rating Scale or Young Manic Rating Scale for schizophrenia, depression or manic patients, respectively. The patients were subsequently subjected to a 36-item short-form Health Survey for quality-of-life assessment.

Results: The quality of life of patients with schizophrenia (n = 92) was no different from those with major mood disorder (n = 71) [p > 0.05]. Quality of life in terms of overall mental health among patients with schizophrenia was significantly and positively associated with ethnicity, employment status, and type of antipsychotic drug treatment (p < 0.05). Being Chinese and employed was associated with better quality of life in terms of overall mental health. Quality of life pertaining to overall physical health of patients with schizophrenia was better in those who were employed and being treated with atypical antipsychotics. Quality of life in patients with major mood disorder was significantly associated with ethnicity, type of antidepressants used, and number of admissions (p < 0.05).

Conclusion: Though schizophrenia has often been considered a chronic disease with poor outcome, our study showed that quality of life of the patients was comparable to those with major mood disorder.

Key words: Mood disorders; Quality of life; Schizophrenia

Introduction

According to a study among patients with schizophrenia, the quality of life (QOL) living in the community was less satisfactory than that of healthy controls in the general population.1 Larsen and Gerlach,2 however, found no differences when their patients were compared to the general population. Depression is a common chronic and recurrent illness, which adversely affects longevity and QOL both during the episode and potentially for the remainder of life.3 It has been estimated that, by 2020, major depression will be the second most frequent cause of disability in the world.4

Conventional versus atypical antipsychotics and antidepressants have different side-effects and therapeutic profiles, both of which influence QOL.5,6 Although the effectiveness of antipsychotic drugs against positive symptoms has been demonstrated in many studies, their different effects on QOL and on long-term compliance remain unclear.7 A study by Tempier and Pawliuk8 on the influence of novel antipsychotics reported that recipients of these drugs scored lower in terms of QOL than those taking older drugs. Another study, however, found that taking atypical antipsychotics was associated with a better QOL than subjects receiving conventional antipsychotics.7

The objective of this study was therefore to examine the relationship between QOL of patients with schizophrenia and major mood disorder (both in remission), in relation to demographic profiles, illness factors, and types of drugs (typical and atypical) being used.

Study Design

Instruments

This was a cross-sectional study conducted in the outpatient psychiatric clinic at the Hospital Universiti Kebangsaan, Malaysia. Study instruments included: (1) the Brief Psychiatric Rating Scale (BPRS)9; (2) the 17-item Hamilton Depressive Scale (HAM-D)10; (3) the Young Manic Rating Scale (YMRS)11; and (4) the Medical Outcomes Study (MOS) 36-item Short Form (SF-36) questionnaire.12

Patients with schizophrenia and major mood disorder who attended the psychiatric clinic from June 2002 to December 2002 and fulfilled the inclusion criteria of this study were recruited. …

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