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, 陈明妮, 党金, 等. 住院精神分裂症患者生活质量调查及与认知功能和社会支持的关系分析. 现代生物医学进展, 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.	招日兰, 温财文, 陈康霞, 等. 调查门诊精神分裂症患者睡眠紊乱发生率并分析睡眠质量影响因素与对策. 世界睡眠医学杂志, 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, 谢晖, 魏娇娇, 等. 抑郁情绪在社区老年人睡眠障碍和衰弱之间的中介作用. 国际老年医学杂志, 2022, 43(2): 136-140.
11.	范肖冬. ICD-10 精神与行为障碍分类(临床描述与诊断要点). 北京: 人民卫生出版社, 1993.
12.	余林花, 王铁虎. 复发性精神分裂症患者生活质量状况调查及影响因素分析. 中华全科医学, 2022, 20(5): 821-823, 858.
13.	ZUNG WW. A self-rating depression scale. Arch Gen Psychiatry, 1965, 12: 63-70.
14.	刘新良. 抑郁自评量表在抑郁症诊断中的应用. 中国航天工业医药, 2001(6): 39-40.
15.	彭慧, 张一英, 季莹, 等. 农村地区女性自评抑郁量表中文版的信度效度分析. 上海医药, 2013, 34(14): 20-23.
16.	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究. 中华精神科杂志, 1996(2): 103-107.
17.	路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析. 重庆医学, 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.	骆宏. 精神分裂症患者生活质量量表(SQLS)中文版: 修订及临床应用研究. 杭州: 浙江大学, 2002.
21.	温忠麟, 叶宝娟. 有调节的中介模型检验方法: 竞争还是替补?. 心理学报, 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. 精神分裂症患者抑郁症状的心理护理干预及实施效果分析. 黔南民族医专学报, 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.	陈兵, 朱晓丹, 周永玲, 等. 负性情绪在精神分裂症患者睡眠与复发关系间的中介作用分析. 护理实践与研究, 2021, 18(16): 2371-2375.
27.	晋铭铭, 罗迅. 马斯洛需求层次理论浅析. 管理观察, 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.	奚兴, 郭桂芳. 社区老年人衰弱现状及其影响因素研究. 中国护理管理, 2014, 14(12): 1315-1319.
32.	侯苹, 薛慧萍, 吴琳凤, 等. 老年人衰弱影响因素的 Meta 分析. 中国老年学杂志, 2019, 39(6): 1385-1389.

1. 富卓琪, 陈明妮, 党金, 等. 住院精神分裂症患者生活质量调查及与认知功能和社会支持的关系分析. 现代生物医学进展, 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. 招日兰, 温财文, 陈康霞, 等. 调查门诊精神分裂症患者睡眠紊乱发生率并分析睡眠质量影响因素与对策. 世界睡眠医学杂志, 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, 谢晖, 魏娇娇, 等. 抑郁情绪在社区老年人睡眠障碍和衰弱之间的中介作用. 国际老年医学杂志, 2022, 43(2): 136-140.
11. 范肖冬. ICD-10 精神与行为障碍分类(临床描述与诊断要点). 北京: 人民卫生出版社, 1993.
12. 余林花, 王铁虎. 复发性精神分裂症患者生活质量状况调查及影响因素分析. 中华全科医学, 2022, 20(5): 821-823, 858.
13. ZUNG WW. A self-rating depression scale. Arch Gen Psychiatry, 1965, 12: 63-70.
14. 刘新良. 抑郁自评量表在抑郁症诊断中的应用. 中国航天工业医药, 2001(6): 39-40.
15. 彭慧, 张一英, 季莹, 等. 农村地区女性自评抑郁量表中文版的信度效度分析. 上海医药, 2013, 34(14): 20-23.
16. 刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究. 中华精神科杂志, 1996(2): 103-107.
17. 路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析. 重庆医学, 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. 骆宏. 精神分裂症患者生活质量量表(SQLS)中文版: 修订及临床应用研究. 杭州: 浙江大学, 2002.
21. 温忠麟, 叶宝娟. 有调节的中介模型检验方法: 竞争还是替补?. 心理学报, 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. 精神分裂症患者抑郁症状的心理护理干预及实施效果分析. 黔南民族医专学报, 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. 陈兵, 朱晓丹, 周永玲, 等. 负性情绪在精神分裂症患者睡眠与复发关系间的中介作用分析. 护理实践与研究, 2021, 18(16): 2371-2375.
27. 晋铭铭, 罗迅. 马斯洛需求层次理论浅析. 管理观察, 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. 奚兴, 郭桂芳. 社区老年人衰弱现状及其影响因素研究. 中国护理管理, 2014, 14(12): 1315-1319.
32. 侯苹, 薛慧萍, 吴琳凤, 等. 老年人衰弱影响因素的 Meta 分析. 中国老年学杂志, 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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