Relationship between depression and quality of life in schizophrenic patients: chain mediating effect analysis_West China Medical Journal

Authors：

HOU Xiaofeng ¹ , MA Xiucheng ¹ , YANG Cui ¹ , JIAN Na ² , YAN Mao ³ , GAN Qianjiao ⁴ , TANG Xiaowei ⁵ ,  WU Dongmei ⁶

1. School of Nursing, Chengdu Medical College, Chengdu, Sichuan 610083, P. R. China;
2. Nursing Department, Chengdu Jinxin Psychiatric Hospital, Chengdu, Sichuan 610011, P. R. China;
3. Nursing Department, Dujiangyan Mental Health Center, Chengdu, Sichuan 611830, P. R. China;
4. Nursing Department, the Fourth People’s Hospital of Pengzhou, Chengdu, Sichuan 611900, P. R. China;
5. Psychiatric Rehabilitation Department, the Fourth People’s Hospital of Pengzhou, Chengdu, Sichuan 611900, P. R. China;
6. Nursing Department, the Fourth People’s Hospital of Chengdu, Chengdu, Sichuan 610036, P. R. China;

Corresponding?author：

WU Dongmei, Email: wudongmei_2001@163.com

Keywords：

Schizophrenia; sleep quality; weakness; depression; quality of life

DOI：

10.7507/1002-0179.202208020

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Objective To explore the relationship between depression and quality of life in schizophrenic patients, and the mediating role of sleep quality and weakness. Methods We selected inpatients with schizophrenia from 4 secondary and above psychiatric hospitals in Chengdu for questionnaire survey by convenient sampling method between March and July 2022. The questionnaires included general demographic data, disease-related questionnaire, Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fried Frailty Phenotype (FFP) and Schizophrenia Quality of Life Scale (SQLS). Results A total of 594 patients were included, including 373 males (62.8%) and 221 females (37.2%). The univariate analysis of the factors affecting the quality of life of the patients showed that there was no significant difference in the age, sex, only child or not, education level, course of schizophrenia, and combined medication (P>0.05), except for the family history of mental disorders (P<0.05). SQLS score was positively correlated with SDS score (r=0.635, P<0.001), PSQI score (r=0.402, P<0.001) and FFP score (r=0.327, P<0.001). The mediation of sleep quality and weakness on depression and quality of life are significant, and chain-mediated effect of depression and quality of life was significant. Conclusion The depression level of schizophrenia patients can not only directly affect their quality of life, but also indirectly affect their quality of life through the mediation of sleep quality, weakness and chain mediation of sleep quality and weakness.

Citation： HOU Xiaofeng, MA Xiucheng, YANG Cui, JIAN Na, YAN Mao, GAN Qianjiao, TANG Xiaowei, WU Dongmei. Relationship between depression and quality of life in schizophrenic patients: chain mediating effect analysis. West China Medical Journal, 2023, 38(2): 240-245. doi: 10.7507/1002-0179.202208020 Copy

1.	富卓琪, 陳明妮, 黨金, 等. 住院精神分裂癥患者生活質量調查及與認知功能和社會支持的關系分析. 現代生物醫學進展, 2021, 21(20): 3893-3897.
2.	Bullinger M, Kuhn J, Leopold K, et al. Quality of life as a target criterion in schizophrenia therapy. Fortschr Neurol Psychiatr, 2019, 87(6): 348-356.
3.	Wang XQ, Petrini MA, Morisky DE. Predictors of quality of life among Chinese people with schizophrenia. Nurs Health Sci, 2017, 19(2): 142-148.
4.	招日蘭, 溫財文, 陳康霞, 等. 調查門診精神分裂癥患者睡眠紊亂發生率并分析睡眠質量影響因素與對策. 世界睡眠醫學雜志, 2022, 9(4): 777-779.
5.	Wang WL, Zhou YQ, Chai NN, et al. Sleep disturbance and quality of life in clinically stable inpatients with schizophrenia in rural China. Qual Life Res, 2020, 29(10): 2759-2768.
6.	Pearson E, Siskind D, Hubbard RE, et al. Frailty and severe mental illness: a systematic review and narrative synthesis. J Psychiatr Res, 2022, 147: 166-175.
7.	Tsai MT, Lee SM, Chen HK, et al. Association between frailty and its individual components with the risk of falls in patients with schizophrenia spectrum disorders. Schizophr Res, 2018, 197: 138-143.
8.	Soysal P, Veronese N, Thompson T, et al. Relationship between depression and frailty in older adults: a systematic review and meta-analysis. Ageing Res Rev, 2017, 36: 78-87.
9.	Vanleerberghe P, De Witte N, Claes C, et al. The association between frailty and quality of life when aging in place. Arch Gerontol Geriatr, 2019, 85: 103915.
10.	汪晨晨, 謝暉, 魏嬌嬌, 等. 抑郁情緒在社區老年人睡眠障礙和衰弱之間的中介作用. 國際老年醫學雜志, 2022, 43(2): 136-140.
11.	范肖冬. ICD-10 精神與行為障礙分類(臨床描述與診斷要點). 北京: 人民衛生出版社, 1993.
12.	余林花, 王鐵虎. 復發性精神分裂癥患者生活質量狀況調查及影響因素分析. 中華全科醫學, 2022, 20(5): 821-823, 858.
13.	ZUNG WW. A self-rating depression scale. Arch Gen Psychiatry, 1965, 12: 63-70.
14.	劉新良. 抑郁自評量表在抑郁癥診斷中的應用. 中國航天工業醫藥, 2001(6): 39-40.
15.	彭慧, 張一英, 季瑩, 等. 農村地區女性自評抑郁量表中文版的信度效度分析. 上海醫藥, 2013, 34(14): 20-23.
16.	劉賢臣, 唐茂芹, 胡蕾, 等. 匹茲堡睡眠質量指數的信度和效度研究. 中華精神科雜志, 1996(2): 103-107.
17.	路桃影, 李艷, 夏萍, 等. 匹茲堡睡眠質量指數的信度及效度分析. 重慶醫學, 2014, 43(3): 260-263.
18.	Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
19.	Wilkinson G, Hesdon B, Wild D, et al. Self-report quality of life measure for people with schizophrenia: the SQLS. Br J Psychiatry, 2000, 177: 42-46.
20.	駱宏. 精神分裂癥患者生活質量量表(SQLS)中文版: 修訂及臨床應用研究. 杭州: 浙江大學, 2002.
21.	溫忠麟, 葉寶娟. 有調節的中介模型檢驗方法: 競爭還是替補?. 心理學報, 2014, 46(5): 714-726.
22.	Guo Y, Qu S, Qin H. Study of the relationship between self-stigma and subjective quality of life for individuals with chronic schizophrenia in the community. Gen Psychiatr, 2018, 31(3): e100037.
23.	江蓉. 精神分裂癥患者抑郁癥狀的心理護理干預及實施效果分析. 黔南民族醫專學報, 2022, 35(1): 68-70.
24.	Chrostek A, Grygiel P, Anczewska M, et al. The intensity and correlates of the feelings of loneliness in people with psychosis. Compr Psychiatry, 2016, 70: 190-199.
25.	Kaskie RE, Graziano B, Ferrarelli F. Schizophrenia and sleep disorders: links, risks, and management challenges. Nat Sci Sleep, 2017, 9: 227-239.
26.	陳兵, 朱曉丹, 周永玲, 等. 負性情緒在精神分裂癥患者睡眠與復發關系間的中介作用分析. 護理實踐與研究, 2021, 18(16): 2371-2375.
27.	晉銘銘, 羅迅. 馬斯洛需求層次理論淺析. 管理觀察, 2019(16): 77-79.
28.	Wang S, Cardieri B, Mo Lin H, et al. Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients. Brain Behav, 2021, 11(6): e02164.
29.	Kishimoto T, Hagi K, Kurokawa S, et al. Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies. Lancet Psychiatry, 2021, 8(5): 387-404.
30.	Higgins-Chen AT, Boks MP, Vinkers CH, et al. Schizophrenia and epigenetic aging biomarkers: increased mortality, reduced cancer risk, and unique clozapine effects. Biol Psychiatry, 2020, 88(3): 224-235.
31.	奚興, 郭桂芳. 社區老年人衰弱現狀及其影響因素研究. 中國護理管理, 2014, 14(12): 1315-1319.
32.	侯蘋, 薛慧萍, 吳琳鳳, 等. 老年人衰弱影響因素的 Meta 分析. 中國老年學雜志, 2019, 39(6): 1385-1389.

1. 富卓琪, 陳明妮, 黨金, 等. 住院精神分裂癥患者生活質量調查及與認知功能和社會支持的關系分析. 現代生物醫學進展, 2021, 21(20): 3893-3897.
2. Bullinger M, Kuhn J, Leopold K, et al. Quality of life as a target criterion in schizophrenia therapy. Fortschr Neurol Psychiatr, 2019, 87(6): 348-356.
3. Wang XQ, Petrini MA, Morisky DE. Predictors of quality of life among Chinese people with schizophrenia. Nurs Health Sci, 2017, 19(2): 142-148.
4. 招日蘭, 溫財文, 陳康霞, 等. 調查門診精神分裂癥患者睡眠紊亂發生率并分析睡眠質量影響因素與對策. 世界睡眠醫學雜志, 2022, 9(4): 777-779.
5. Wang WL, Zhou YQ, Chai NN, et al. Sleep disturbance and quality of life in clinically stable inpatients with schizophrenia in rural China. Qual Life Res, 2020, 29(10): 2759-2768.
6. Pearson E, Siskind D, Hubbard RE, et al. Frailty and severe mental illness: a systematic review and narrative synthesis. J Psychiatr Res, 2022, 147: 166-175.
7. Tsai MT, Lee SM, Chen HK, et al. Association between frailty and its individual components with the risk of falls in patients with schizophrenia spectrum disorders. Schizophr Res, 2018, 197: 138-143.
8. Soysal P, Veronese N, Thompson T, et al. Relationship between depression and frailty in older adults: a systematic review and meta-analysis. Ageing Res Rev, 2017, 36: 78-87.
9. Vanleerberghe P, De Witte N, Claes C, et al. The association between frailty and quality of life when aging in place. Arch Gerontol Geriatr, 2019, 85: 103915.
10. 汪晨晨, 謝暉, 魏嬌嬌, 等. 抑郁情緒在社區老年人睡眠障礙和衰弱之間的中介作用. 國際老年醫學雜志, 2022, 43(2): 136-140.
11. 范肖冬. ICD-10 精神與行為障礙分類(臨床描述與診斷要點). 北京: 人民衛生出版社, 1993.
12. 余林花, 王鐵虎. 復發性精神分裂癥患者生活質量狀況調查及影響因素分析. 中華全科醫學, 2022, 20(5): 821-823, 858.
13. ZUNG WW. A self-rating depression scale. Arch Gen Psychiatry, 1965, 12: 63-70.
14. 劉新良. 抑郁自評量表在抑郁癥診斷中的應用. 中國航天工業醫藥, 2001(6): 39-40.
15. 彭慧, 張一英, 季瑩, 等. 農村地區女性自評抑郁量表中文版的信度效度分析. 上海醫藥, 2013, 34(14): 20-23.
16. 劉賢臣, 唐茂芹, 胡蕾, 等. 匹茲堡睡眠質量指數的信度和效度研究. 中華精神科雜志, 1996(2): 103-107.
17. 路桃影, 李艷, 夏萍, 等. 匹茲堡睡眠質量指數的信度及效度分析. 重慶醫學, 2014, 43(3): 260-263.
18. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
19. Wilkinson G, Hesdon B, Wild D, et al. Self-report quality of life measure for people with schizophrenia: the SQLS. Br J Psychiatry, 2000, 177: 42-46.
20. 駱宏. 精神分裂癥患者生活質量量表(SQLS)中文版: 修訂及臨床應用研究. 杭州: 浙江大學, 2002.
21. 溫忠麟, 葉寶娟. 有調節的中介模型檢驗方法: 競爭還是替補?. 心理學報, 2014, 46(5): 714-726.
22. Guo Y, Qu S, Qin H. Study of the relationship between self-stigma and subjective quality of life for individuals with chronic schizophrenia in the community. Gen Psychiatr, 2018, 31(3): e100037.
23. 江蓉. 精神分裂癥患者抑郁癥狀的心理護理干預及實施效果分析. 黔南民族醫專學報, 2022, 35(1): 68-70.
24. Chrostek A, Grygiel P, Anczewska M, et al. The intensity and correlates of the feelings of loneliness in people with psychosis. Compr Psychiatry, 2016, 70: 190-199.
25. Kaskie RE, Graziano B, Ferrarelli F. Schizophrenia and sleep disorders: links, risks, and management challenges. Nat Sci Sleep, 2017, 9: 227-239.
26. 陳兵, 朱曉丹, 周永玲, 等. 負性情緒在精神分裂癥患者睡眠與復發關系間的中介作用分析. 護理實踐與研究, 2021, 18(16): 2371-2375.
27. 晉銘銘, 羅迅. 馬斯洛需求層次理論淺析. 管理觀察, 2019(16): 77-79.
28. Wang S, Cardieri B, Mo Lin H, et al. Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients. Brain Behav, 2021, 11(6): e02164.
29. Kishimoto T, Hagi K, Kurokawa S, et al. Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies. Lancet Psychiatry, 2021, 8(5): 387-404.
30. Higgins-Chen AT, Boks MP, Vinkers CH, et al. Schizophrenia and epigenetic aging biomarkers: increased mortality, reduced cancer risk, and unique clozapine effects. Biol Psychiatry, 2020, 88(3): 224-235.
31. 奚興, 郭桂芳. 社區老年人衰弱現狀及其影響因素研究. 中國護理管理, 2014, 14(12): 1315-1319.
32. 侯蘋, 薛慧萍, 吳琳鳳, 等. 老年人衰弱影響因素的 Meta 分析. 中國老年學雜志, 2019, 39(6): 1385-1389.

West China Medical Journal

Relationship between depression and quality of life in schizophrenic patients: chain mediating effect analysis

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