Qualidade de vida na esquizofrenia: fatores associados

Abstract

Introduction: Evaluation of the quality of life (QOL) emerged in the last decades as an important concept. The impact of chronic illnesses as well as therapeutic interventions has been evaluated under the view of QOL. This study aimed to investigate the sociodemographic and clinical variables related to a low QOL in patients with schizophrenia. Method: A cross-sectional study was carried out in order to evaluate the QOL in outpatients, attending two Reference Centers for Mental Health Care in two cities located in Minas Gerais State. The sample included 123 outpatients from Divinópolis and 150 from Belo Horizonte City. All patients were interviewed using the QOL-BR scale and a clinical and sociodemographic questionnaire. In one site, a specific scale for depression - the Calgary scale - was also included. Comparisons between patients characteristics had been made using of theQui-square, Fishers or Mann-Whitney test. Multivariate analyses included: binary, ordinal logistic regression and decisions tree using CHAID and CART algorithms. Results: Considering the patients from Divinópolis, low QOL in the global scale was associated with:being male and single. The associated factors with low QOL in the specific domains were: low income, low education level, being under the prescription of three or more psychiatric medications, having demonstrated psychomotor agitation during the interview and beingunder follow-up care. Differences in the QOL for men and women were found, especially in the occupational domain, where women had better QOL than men. Single men and women presented lower QOL than their married pairs. Longer duration of the illness (> 5 years), although significant for both men and women, in the logistic model remained associated only with men. Patients from Belo Horizonte presented a prevalence of 56% of depression. Depressed patients had lower QOL in the global scale and occupational domain. For patients with low QOL, presence of symptoms, number of medicines taken and absence of home activities were associated with depression, while for those with better QOL, only duration of the illness remained associated. Conclusion: Improving the QOL of schizophrenic patients has been one of the most important objective in the mental health care. The identification ofspecific aspects pointed out in this investigation may help health services to build up strategies aiming to promote the QOL of their patients.