A CASE CONTROL STUDY: DETERMINANTS OF QUALITY OF LIFE FOR INDIVIDUALS LIVING WITH SCHIZOPHRENIA IN GORONTALO, INDONESIA
DOI:
https://doi.org/10.37268/mjphm/vol.25/no.2/art.3184Keywords:
Schizophrenia, quality of life, individual characteristics, Schizophrenia quality of Life, individual characteristics, Gorontalo, Indonesia.Abstract
Quality of life (QOL) has consistently been a significant consideration regarding the impact of mental illnesses, particularly schizophrenia. Despite this, relatively few studies have measured QOL in this population, with most focusing on patients in hospital settings. This study intends to examine the factors associated with QOL among individuals living with schizophrenia who are receiving treatment in primary health care facilities (puskesmas) in Gorontalo, Indonesia. A case-control study was conducted to investigate QOL as the outcome measure. The cases comprised individuals aged 18 and above living with schizophrenia who reported a poor QOL, while the controls were individuals with schizophrenia, but who reported a good QOL. To assess the risk factors associated with QOL among this population, a multivariate logistic regression analysis was employed. Among the 116 subjects in the study, the majority were men aged 36 to 45, with many being single and unemployed; in contrast, most of the controls were employed. Both groups primarily consisted of individuals with no reported monthly income. Findings indicated that lower educational attainment (aOR = 7.92; 95% CI = 1.28 – 48.98), being single (aOR = 5.50; 95% CI = 1.56 – 19.41), and lacking a monthly income (aOR = 4.82; 95% CI = 1.67 – 13.94) significantly increased the risk of poor QOL. As a conclusion, the study underscores the importance of addressing educational level, marital status, and income in improving QOL for individuals with schizophrenia and suggests a focus on supporting single individuals with lower education and absent income in public health initiatives.
References
WHO. Schizophrenia. WHO, https://www.who.int/news-room/fact-sheets/detail/schizophrenia (2022, accessed 5 April 2025).
Kementerian Kesehatan RI. Report of Basic Health Research 2018 [in Bahasa: Laporan Riset Kesehatan Dasar 2018], http://www.yankes.kemkes.go.id/assets/downloads/PMK No. 57 Tahun 2013 tentang PTRM.pdf (2018).
Cai T, Verze P, Bjerklund Johansen TE. The Quality of Life Definition: Where Are We Going? Uro 2021; 1: 14–22.
Desalegn D, Girma S, Tessema W, et al. Quality of Life and Associated Factors among Patients with Schizophrenia Attending Follow-Up Treatment at Jimma Medical Center, Southwest Ethiopia: A Cross-Sectional Study. Psychiatry J 2020; 2020: 1–7.
Hofer A, Mizuno Y, Wartelsteiner F, et al. Quality of life in schizophrenia and bipolar disorder: The impact of symptomatic remission and resilience. European Psychiatry 2017; 46: 42–47.
Joshi A, Joshy J, Mathew KA, et al. Quality of life in Schizophrenia patients with and
Malaysian Journal of Public Health Medicine 2025, Vol. 25 (2): 84-90
without adequate pharmaceutical care: A randomized controlled study. Clin Epidemiol Glob Health; 20. Epub ahead of print 1 March 2023. DOI: 10.1016/j.cegh.2022.101208.
Gosh Woldemariam A, Thupayagale-Tshweneagae. G. Quality of Life of People with Schizophrenia Compared to Controls: A Case- Control Study. J Psychiatry Psychiatr Disord; 07. Epub ahead of print 2023. DOI: 10.26502/jppd.2572-519x0184.
Desalegn D, Girma S, Abdeta T. Quality of life and its association with psychiatric symptoms and socio-demographic characteristics among people with schizophrenia: A hospital-based cross-sectional study. PLoS One; 15. Epub ahead of print 1 February 2020. DOI: 10.1371/journal.pone.0229514.
Mahmud MHS, Yeasmin B, Mandal S. Quality of life of schizophrenic patients in a tertiary care hospital in Bangladesh. Bangladesh Journal of Psychiatry 2017; 29: 30–34.
BPS-Statistics Indonesia. Statistik Indonesia 2021 [Statistical Yearbook of Indonesia 2021], https://www.bps.go.id/publication/2020/04/29/e9011b3155d45d70823c141f/statistik-indonesia-2020.html (2021, accessed 2 February 2025).
Dinas Kesehatan Provinsi Gorontalo. Data Dinas Kesehatan Provinsi Gorontalo [Data of Gorontalo Provincial Health Office], https://dinkes-gorontaloprov.com/data/ (2022, accessed 2 February 2025).
WHO. WHOQOL User Manual, https://iris.who.int/bitstream/handle/10665/77932/WHO_HIS_HSI_Rev.2012.03_eng.pdf?sequence=1 (2012, accessed 8 December 2023).
Li XJ, Wu JH, Liu JB, et al. The influence of marital status on the social dysfunction of schizophrenia patients in community. Int J Nurs Sci 2015; 2: 149–152.
Rippon I, Quinn C, Martyr A, et al. The impact of relationship quality on life satisfaction and well-being in dementia caregiving dyads: findings from the IDEAL study. Aging Ment Health 2020; 24: 1411–1420.
Daely S, Nuraini T, Gayatri D, et al. Impacts of age and marital status on the elderly’s quality of life in an elderly social institution. 2022.
Puciato D, Rozpara M, Bugdol M, et al. Socio-economic correlates of quality of life in
single and married urban individuals: a Polish case study. Health Qual Life Outcomes; 20. Epub ahead of print 1 December 2022. DOI: 10.1186/s12955-022-01966-2.
Nath S, Ramachandran P, Sehlo M, et al. Relationship between social support and schizophrenia relapse among patients with schizophrenia on follow-up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: A case-control study. Front Psychiatry; 13. Epub ahead of print 2022. DOI: 10.3389/fpsyt.2022.980614.
Fulford D, Holt DJ. Social Withdrawal, Loneliness, and Health in Schizophrenia: Psychological and Neural Mechanisms. Schizophr Bull 2023; 49: 1138–1149.
Trémeau F, Antonius D, Malaspina D, et al. Loneliness in schizophrenia and its possible correlates. An exploratory study. Psychiatry Res 2016; 246: 211–217.
Eglit GML, Palmer BW, Martin AS, et al. Loneliness in schizophrenia: Construct clarification, measurement, and clinical relevance. PLoS One; 13. Epub ahead of print 1 March 2018. DOI: 10.1371/journal.pone.0194021.
Liao H-Y, Lee Y, Hsu S-T, et al. Loneliness in Patients with Schizophrenia. Taiwanese Journal of Psychiatry 2021; 35: 59–63.
Petrovic AD, Barjaktarevic AM, Kostic OZ, et al. Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study. Open Medicine (Poland); 19. Epub ahead of print 1 January 2024. DOI: 10.1515/med-2024-0947.
Celik SS, Celik Y, Hikmet N, et al. Factors Affecting Life Satisfaction of Older Adults in Turkey. Int J Aging Hum Dev 2018; 87: 392–414.
Guedes de Pinho LM, Pereira AM de S, Chaves CMCB. Quality of life in schizophrenic patients: The influence of sociodemographic and clinical characteristics and satisfaction with social support. Trends Psychiatry Psychother 2018; 40: 202–209.
He Y, Tanaka A, Kishi T, et al. Recent findings on subjective well-being and physical, psychiatric, and social comorbidities in individuals with schizophrenia: A literature review. Neuropsychopharmacology Reports 2022; 42: 430–436.
Malaysian Journal of Public Health Medicine 2025, Vol. 25 (2): 84-90
de Zwarte SMC, Brouwer RM, Agartz I, et al. Intelligence, educational attainment, and brain structure in those at familial high-risk for schizophrenia or bipolar disorder. Hum Brain Mapp 2022; 43: 414–430.
Davtalab Esmaeili E, Golestani M, Yazdani M, et al. Quality of Life and Socioeconomic Status in Northwest of Iran: First Wave of the Persian Traffic Cohort Study. J of Prevention 2024; 45: 751–764.
Bielderman A, de Greef MHG, Krijnen WP, et al. Relationship between socioeconomic status and quality of life in older adults: a path analysis. Qual Life Res 2015; 24: 1697–1705.
Fu Y, Zhang S, Guo X, et al. Socioeconomic status and quality of life among older adults with hypertension in rural Shandong, China: a mediating effect of social capital. Front Public Health; 11. Epub ahead of print 2023. DOI: 10.3389/fpubh.2023.1248291.
Henriques A, Silva S, Severo M, et al. Socioeconomic position and quality of life among older people: The mediating role of
social support. Prev Med (Baltim); 135. Epub ahead of print 1 June 2020. DOI: 10.1016/j.ypmed.2020.106073.
Addae EA. The mediating role of social capital in the relationship between socioeconomic status and adolescent wellbeing: Evidence from Ghana. BMC Public Health; 20. Epub ahead of print 7 January 2020. DOI: 10.1186/s12889-019-8142-x.
Wang J, Geng L. Effects of socioeconomic status on physical and psychological health: Lifestyle as a mediator. Int J Environ Res Public Health; 16. Epub ahead of print 2 January 2019. DOI: 10.3390/ijerph16020281.
Daniel H, Bornstein SS, Kane GC. Addressing social determinants to improve patient care and promote health equity: An American college of physicians position paper. Ann Intern Med 2018; 168: 577–578.
