Variables Influencing Subjective Well-Being in Patients with Schizophrenia

Jinseung Oh; Jong-Woo Paik; Moon-Soo Lee; Changsu Han; Hyun-Ghang Jeong; Byung-Joo Ham; Yong-Ku Kim; Seung-Hyun Kim; Young-Hoon Ko

doi:10.16946/kjsr.2014.17.2.93

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Oh, Paik, Lee, Han, Jeong, Ham, Kim, Kim, and Ko: Variables Influencing Subjective Well-Being in Patients with Schizophrenia

Original Article

Korean J Schizophr Res 2014;17(2):93-99.

Published online: 20 January 2014

DOI: https://doi.org/10.16946/kjsr.2014.17.2.93

Variables Influencing Subjective Well-Being in Patients with Schizophrenia

Jinseung Oh, MD¹, Jong-Woo Paik, MD, PhD³, Moon-Soo Lee, MD, PhD¹, Changsu Han, MD, PhD², Hyun-Ghang Jeong, MD, PhD¹, Byung-Joo Ham, MD, PhD³, Yong-Ku Kim, MD, PhD², Seung-Hyun Kim, MD, PhD^1,, Young-Hoon Ko, MD, PhD²

¹Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea

²Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea

³Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea

⁴Department of Psychiatry, School of Medicine, Kyung Hee University, Seoul, Korea

Address for correspondence: Seung-Hyun Kim, Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea Tel: 02-2626-3162, Fax: 852-1937 E-mail: gurokim@gmail.com Funding for this study was provided by CJ HealthCare. CJ HealthCare had no further role in the study design; in the collection, analysis or interpretation of data; in the writing of the manuscript; or in the decision to submit the paper for publication. Its contents are solely the responsibility of the authors.

Received 15 September 2014 Revised 25 September 2014 Accepted 30 September 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to analyze the relationship between subjective well-being and other clinical parameters such as sociodemographic and clinical variables, which include positive and negative symptoms, depressive symptoms, insight, and side effects.

Methods

Fifty-one outpatients diagnosed with schizophrenia were recruited in this study. Subjective well-being was assessed using a self-rating scale, the Subjective Well-being under Neuroleptics-Short form (SWN-K). Sociodemographic variables were also evaluated and other evaluations were conducted using the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), Korean Version of the Revised Insight Scale for Psychosis (KISP), and Multidimensional Scale of Perceived Social Support (MSPSS). The relationship between subjective well-being and these clinical variables was assessed.

Results

: Education years and social support scores were positively correlated with the total SWN-K scores, but severity of illness, severity of depression, severity of side effect, and the scores on insight were negatively correlated. The stepwise multiple regression analyses indicated that the total SWN-K score of the patients with schizophrenia was associated with negative symptoms and insight.

Conclusion

: Better insight and more severe negative symptoms in patients with schizophrenia may be associated with worse subjective well-being. Results indicate that careful evaluation of subjective well-being is essential for proper management of patients with schizophrenia.

Keywords: Schizophrenia, Subjective well-being, SWN-K, Insight, Negative symptom.

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Table 1.

Sociodemographic characteristics of the subjects (n=51

	Mean±SD or n (%)
Gender
Male	22 (43.1%)
Female	29 (56.9%)
Marital status
Married/living together	11 (21.6%)
Single	33 (64.7%)
Divorced/separated	07 (13.7%)
Occupation
Unemployed	40 (80.0%)
Employed	11 (20.0%)
Current neuroleptics
Aripiprazole	05 (09.8%)
Olanzapine	07 (13.7%)
Paliperidone	06 (11.8%)
Risperidone	11 (21.6%)
Ziprasidone	04 (07.8%)
Quetiapine	07 (13.7%)
Amisulpride	11 (21.6%)
Age (years)	38.96±11.57
Educational level (years)	12.22±02.99
Illness onset age (years)	28.06±11.25
Duration of illness (years)	10.10±08.07
Frequency of hospitalization	01.39±01.33

Table 2.

Clinical characteristics of the subjects (n=51)

	Mean±SD
SWN-K
Mental functioning	14.55±04.09
Self-control	15.20±04.18
Emotional regulation	15.90±04.06
Physical functioning	15.43±04.21
Social integration	14.75±03.83
Total	75.82±16.80
PANSS score
Positive score	10.67±03.94
Negative score	14.71±06.72
General score	26.73±08.38
Total score	52.10±17.32
CDSS score	02.56±02.73
LUNSERS
Extrapyramidal	05.29±04.59
Psychic	12.43±07.77
Anticholinergic	03.53±03.38
Other autonomic	03.45±03.38
Allergic reaction	01.86±02.41
Hormonal	02.57±02.77
Miscellaneous	03.14±02.31
Red herrings	05.94±04.79
Total score	32.27±22.10
DAI-10
Subjective positive score	01.73±30.25
Subjective negative score	01.78±02.07
Total score	03.51±04.19
KISP	13.02±05.92
MSPSS
Family score	05.06±01.55
Friends score	03.56±01.74
Significant other score	03.95±01.65
Total score	04.19±01.20

SWN-K: Subjective Wellbeing on Neuroleptics-Short form, PANSS: Positive and Negative Syndrome Scale, CDSS: Calgary Depression Scale for Schizophrenia, LUNSERS: Liverpool University Neuroleptic Side Effect Rating Scale, DAI-10: Drug Attitude Inventory-10, KISP: Korean Version of the Revised Insight Scale for Psychosis, MSPSS: Multidimensional Scale of Perceived Social Support

Table 3.

Comparison of the SWN-K scores with demographic data

	SWN-K
	Mean±SD	p-value
Gender
Male	77.32±20.21	0.585
Female	74.69±13.93
Job
Unemployed	76.22±17.48	0.748
Employed	74.36±14.68
Hospitalization
Not hospitalized	70.29±18.22	0.149
Hospitalized	77.92±15.98
Marital status
Married/living together	83.09±15.75	0.232∗
Single	73.12±17.11
Divorced/Separated	77.14±15.38
Education level
High education level^†	77.05±17.38	0.296
Low education level	70.80±13.78

p-values were calculated using the Independent samples t-test. ∗: The one-way ANOVA, Tukey's post-hoc analysis, †: High education level indicates high school graduation or over. SWN-K: Subjective Wellbeing on Neuroleptics-Short form

Table 4.

Bivariate correlations between the SWN-K scores and clinical measures of the subjects (n=51)

	SWN-K
	r	p-value
Age (years)	–0.142	0.321
Education (years)	–0.286	0.042∗
Illness onset age (years)	–0.142	0.322
Duration of illness (years)	–0.021	0.885
PANSS score
Positive score	–0.407	0.003^†
Negative score	–0.362	0.009^†
General score	–0.327	0.019∗
Total score	–0.391	0.005^†
CDSS	–0.457	0.001^†
LUNSERS
Extrapyramidal	–0.583	0.001^†
Psychic	–0.524	0.001^†
Anticholinergic	–0.461	0.001^†
Other autonomic	–0.509	0.001^†
Allergic reaction	–0.324	0.020∗
Hormonal	–0.158	0.267
Miscellaneous	–0.532	0.001^†
Red herrings	–0.549	0.001^†
Total score	–0.564	0.001^†
DAI-10	–0.202	0.155
KISP	–0.701	0.001^†
MSPSS
Family score	–0.543	0.001^†
Friends score	–0.323	0.021∗
Significant other score	–0.286	0.042∗
Total score	–0.520	0.001^†
Digit symbol substitution test	–0.068	0.640
Verbal fluency test	–0.150	0.293
Trail making test A	–0.126	0.382
Trail making test B	–0.124	0.390

p-values were calculated using the Pearson's correlation analysis. ∗: Significant at the 0.05 level (two-tailed), †: Significant at the 0.01 level (two-tailed). SWN-K: Subjective Wellbeing on Neuroleptics-Short form, PANSS: Positive and Negative Syndrome Scale, CDSS: Calgary Depression Scale for Schizophrenia, LUNSERS: Liverpool University Neuroleptic Side Effect Rating Scale, DAI-10: Drug Attitude Inventory-10, KISP: Korean Version of the Revised Insight Scale for Psychosis, MSPSS: Multidimensional Scale of Perceived Social Support

Table 5.

The multiple regression analyses for clinical variables related with subjective wellbeing in the subjects (n=51)

	β	95% C.I.	p-value
KISP	–1.921	–2.477, −1.365	0.001
PANSS negative	e score −0.746	–1.255, −0.238	0.005

KISP: Korean Version of the Revised Insight Scale of Psychosis, PANSS: Positive and Negative Syndrome Scale

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