Refractory schizophrenia: quality of life and associated factors

A cross-sectional study, conducted in the extended western region of Minas Gerais, which included patients with refractory schizophrenia using the antipsychotic, clozapine. For the measurement of quality of life, the Quality of Life Scale was used, specific for patients with schizophrenia. Univariate and multivariate analyses were performed.

Results

A total of 72 patients with a mean age of 42.9 years was part of the study. The overall score of the Quality of Life Scale indicated compromised quality of life, with a greater impairment in the social network domain (median = 2.36). The logistic regression analysis showed factors associated with a better quality of life.

Conclusion

Low quality of life in patients with refractory schizophrenia was found. Physical activity, family income over three times the minimum wage, and having children were associated with a better quality of life.

Schizophrenia/drug therapy; Quality of life; Clozapine/therapeutic use; Metabolic syndrome X

Item	Factors	Mean±SD	Median*	Interquartile range
Item	Factors	Mean±SD	Median*	P25	P75
Interpersonal Relationships		2.5±1.2	2.36	1.71	3.25
1	Household		4.00	2.00	5.00
2	Friends		2.00	1.00	4.00
3	Acquaintances		2.00	0.25	2.00
4	Social activity		2.00	1.00	2.00
5	Social network		2.00	2.00	4.00
6	Social initiative		2.00	1.00	3.00
7	Withdrawal		2.00	2.00	4.00
Instrumental Role		3.1±1.4	3.00	2.20	4.15
9	Occupational role		2.00	1.00	2.75
10	Work functioning		2.00	0.00	2.75
11	Work level		2.00	0.00	4.00
12	Work satisfaction		4.00	4.00	9.00
17	Time use (aimless activity)		2.00	2.00	4.00
Intrapsychlc Foundations and Interpersonal Relationships		2.8±1.3	2.86	1.89	3.82
8	Socio-sexual relationship		1.00	0.00	2.00
13	Sense of purpose		2.00	1.00	4.00
15	Curiosity		2.00	1.00	3.75
18	Objects		4.00	3.00	6.00
19	Activities		4.00	2.00	4.00
20	Empathy		2.50	2.00	4.00
21	Emotional interaction		4.00	2.00	6.00
Common Objects & Activities		2.8±1.2	2.55	2.02	3.64
14	Motivation		2.00	1.00	3.00
16	Anhedonia		2.00	2.00	4.00

Variables	Global Scale QLS-BR		p-value
Variables	QL VC (n=15)	QL C/U (n=57)	p-value
Sex
Male	8	28	0.772*
Female	7	29
Age
Mean ± standard deviation	43.9±16.0	42.6± 9.1	0.735**
Median (Minimal – Maximal)	44 (30-52)	43 (22-59)
Marital status
Single	14	42	0.164***
With partner	1	15
Educational level
Elementary	10	30	0.227*
High school or above	4	26
Children
None	13	36	0.050*
Yes	1	21
Are you currently working?
Yes	0	7	0.332*
No	15	50
Do you get retirement benefits?
Yes	10	35	0.999***
No	4	17
What is your current household income?
Up to 2 times the MW	13	26	0.004*
3 times the MW or more	1	26
Where do you receive psychiatric treatment?
Public network	13	38	0.203***
Private network	2	19
How long have you been receiving psychiatric treatment?*
Up to 10 years	3	18	0.526***
More than 10 years	10	35
How often do you go to the psychiatrist for consultation?
At least once every six months	3	32	0.019*
Semiannually or annually	10	22
Have you ever been hospitalized in a psychiatric hospital?
Yes	12	44	0.999***
No	3	13
How long have you used clozapine?
Up to 5 years	6	13	0.180***
More than 5 years	7	38
Hypertension
No	12	46	0.999***
Yes	3	11
Diabetes
No	15	46	0.105***
Yes	0	11
How many medicines do you take per day?
Up to 3 medications	2	18	0.704***
4 or more	7	32
Do you think the medication that you take affects you?
No	10	37	0.313***
Yes	2	20
Do you smoke?
No	12	42	0.746***
Yes	3	15
Do you currently consume alcohol?
No	0	2	0.999***
Yes	15	54
Do you practice any physical activity?
No	11	32	0.044***
Yes	1	24
Metabolic syndrome			0.529*
No	9	29
Yes	6	28

Factors	p-value*	OR	CI95% for OR
Factors	p-value*	OR	Lower limit	Upper limit
Household income
Up to 2 times MW	-	1.00	-	-
3 times MW or higher	0.020	15.98	1.55	164.94
Physical activity
No	-	1.00	-	-
Yes	0.006	25.24	2.48	257.12
Children
No	-	1.00	-	-
Yes	0.007	24.92	2.43	255.48

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author. Pedro Henrique Batista de Freitas. Sebastião Gonçalves Coelho street, 400, 35501-290, Divinópolis, MG, Brazil. pedrohbf@yahoo.com.br