Sleep disturbance and quality of life in clinically stable inpatients with schizophrenia in rural China.

BACKGROUND: Studies have identified numerous factors that may affect the sleep quality and quality of life (QOL) in outpatients with schizophrenia. However, the clinically stable inpatients who represent a large proportion of the population with schizophrenia in China have not received enough attention. The present study was performed to explore the sociodemographic and clinical correlates of sleep disturbance and QOL in clinically stable inpatients with schizophrenia in rural China. METHODS: A cross-sectional study was designed, and 207 clinically stable inpatients with schizophrenia were selected from Chifeng Anding Hospital, located in Inner Mongolia Autonomous Region, in northern China. All subjects were interviewed by the same investigator using standardized assessment instruments. QOL and sleep disturbance were measured using the Schizophrenia Quality of Life Scale (SQLS) and Pittsburgh Sleep Quality Index (PSQI), respectively. Univariate and multiple regression analyses were used to identify the factors influencing sleep disturbance and QOL. Antipsychotics taken by individuals were converted into olanzapine equivalent doses as the main confounding factor to be controlled. RESULTS: The prevalence of sleep disturbance was 58%, and sleep disturbance was significantly associated with depression (OR 1.33, 95% CI 1.17-1.52) and coping mechanisms (OR 0.95, 95% CI 0.91-0.98). We observed large differences between the sexes: the QOL of male inpatients with schizophrenia was substantially better than that of female inpatients, with a standard coefficient of 0.19 ± 1.62. Other factors related to QOL were depression (0.42 ± 0.30), hope (- 0.21 ± 0.19), general psychopathology symptoms (0.21 ± 0.24) and personal and social performance (- 0.12 ± 0.07). CONCLUSIONS: The depressive symptoms of inpatients with schizophrenia should receive more attention. More targeted interventions, such as the early identification and treatment of depression, should be promptly administered to improve the patient's hospitalization experience.

Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia.

BACKGROUND: The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association. METHODS: Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model. RESULT: Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope. CONCLUSION: We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.