Surreal illustration of a person walking a tightrope representing the long-term management of schizophrenia.

Unlocking Quality of Life: How Long-Term Care Impacts Schizophrenia Patients

Rhea Morgan in Health & Wellness July 2025 • 5 min read.

"Exploring the complexities of long-term schizophrenia management and its effects on patient well-being."

In recent years, the focus of schizophrenia treatment has expanded beyond symptom management to encompass the overall well-being and quality of life (QoL) of patients. This shift acknowledges that true recovery involves not only reducing symptoms but also enhancing social, occupational, and personal fulfillment.

A key area of interest is understanding how QoL changes over the long term for individuals with chronic schizophrenia. Factors such as community functioning, the level of social support, and the persistence of symptoms can all play a role in shaping a patient's overall experience.

To shed light on this complex issue, researchers are conducting long-term follow-up studies to track changes in QoL among schizophrenia patients and identify factors that contribute to either improvement or decline. This article delves into a study that examines the long-term QoL of patients with chronic schizophrenia, exploring its connection with their symptoms and integration within the community.

The Long View: Assessing Quality of Life Over Time

Surreal illustration of a person walking a tightrope representing the long-term management of schizophrenia.

A research study investigated the quality of life (QoL) of 85 patients diagnosed with schizophrenia, who were considered clinically stable and had previously participated in a study on deficit syndrome in schizophrenia. The study aimed to evaluate how their QoL evolved over time and to identify factors influencing these changes. These patients were initially recruited from two settings: a university general hospital outpatient service (49 patients) and a community-based service (36 patients).

The study used a comprehensive approach, assessing patients with several established instruments. These included the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Calgary Depression Scale, and the Quality of Life Scale (QLS). Additionally, the Personal and Social Performance Scale (PSP) was introduced in the follow-up to measure social functioning, which was not assessed at baseline.

Participant Attrition: Initially, 49 patients were recruited, but some dropped out, were transferred, refused participation, or experienced a change in diagnosis.
Mortality: Three patients died during the follow-up period due to various causes.
Sample Characteristics: Twenty patients completed the reassessment. The mean age at baseline was 36.9 years, with a mental illness duration of 16 years. A majority (75%) were men.
Education & Socioeconomic Status: Participants had an average of 10.7 years of education. A significant number had low socioeconomic status.

The study revealed nuanced insights into the long-term QoL of schizophrenia patients. Some demographic aspects worsened, with fewer patients employed at follow-up. While there was no significant change in the group's overall QLS scores, individual trajectories varied. Some patients experienced significant improvements in their QLS, while others faced a decline. Baseline scores on SANS, SAPS and number of hospitalizations were negatively correlated with follow-up QLS scores. Initial years of schooling were positively correlated with QLS follow-up scores.

Implications and Future Directions

The study's findings suggest that the long-term QoL of individuals with schizophrenia is complex, with outcomes varying significantly among patients. While overall QoL may remain stable for some, others experience improvement or worsening, highlighting the need for personalized care approaches.

The negative correlation between baseline symptom severity (as measured by SANS and SAPS scores) and follow-up QoL underscores the importance of early and effective symptom management. Additionally, the positive association between years of schooling and later QoL suggests that interventions promoting education and cognitive function may have long-term benefits.

Future research should focus on identifying specific factors that contribute to divergent QoL trajectories in schizophrenia. By understanding why some patients thrive while others struggle, clinicians can develop targeted interventions to promote recovery and enhance the overall well-being of individuals living with this chronic condition.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1093/schbul/sby018.1038, Alternate LINK

Title: S251. Quality Of Life Of Chronic Schizophrenia Patients In The Long Term Follow-Up

Subject: Psychiatry and Mental health

Journal: Schizophrenia Bulletin

Publisher: Oxford University Press (OUP)

Authors: Diego Mendes, Gustavo Mustafé, Thalita Fernandes, Thais Martins, Clarissa Dantas

Published: 2018-04-01

Everything You Need To Know

What is this study focused on?

The research centers on understanding the long-term evolution of Quality of Life (QoL) in individuals diagnosed with schizophrenia. Researchers used the Quality of Life Scale (QLS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Calgary Depression Scale, and the Personal and Social Performance Scale (PSP) to evaluate patient outcomes. This study aimed to determine factors that influence these changes, providing insights into how QoL fluctuates over time and its connection with symptoms and community integration.

How did the researchers conduct the study?

The study's methodology involved assessing 85 clinically stable schizophrenia patients who were initially part of a prior study. The patients were assessed using standardized instruments like the SAPS, SANS, QLS, and Calgary Depression Scale. In the follow-up phase, the PSP was used to gauge social functioning, not evaluated in the initial phase. During the follow-up period, the researchers tracked the participants' progress, evaluating how their QoL changed and what factors contributed to those changes.

What were the main findings related to the Quality of Life (QoL) of the patients?

The study examined changes in the Quality of Life (QoL) of schizophrenia patients. Overall QoL scores did not significantly change, however, some patients showed improvements, while others experienced declines. Factors such as the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS), and the number of hospitalizations were negatively correlated with follow-up QLS scores. Conversely, years of schooling had a positive correlation. These findings suggest that individualized care approaches are essential, as the experience varies from patient to patient.

What factors were found to influence the long-term outcomes of these patients?

The study's findings reveal that long-term Quality of Life (QoL) outcomes for schizophrenia patients are varied. Some participants maintained stable QoL, while others saw improvements or declines, highlighting the need for personalized care. Key factors influencing these outcomes include symptom severity as measured by the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). Also, initial educational attainment and the number of hospitalizations. The study emphasizes the complexity of managing schizophrenia and the importance of adapting treatments to meet each patient's unique needs.

What are the main implications of these findings for schizophrenia management?

The implications of this research highlight the importance of individualized care in schizophrenia treatment. The study showed the different trajectories of the Quality of Life (QoL) among patients. The findings support the shift towards treatments that focus on the overall well-being of patients, including social, occupational, and personal fulfillment, beyond just symptom management. The study underscores the need for continuous monitoring and tailored interventions to address the varying needs and experiences of individuals living with schizophrenia, thereby improving long-term outcomes.