Assessing the quality of life of schizophrenia patients and their family caregivers in a Romanian sample: the role of clinical, sociocultural, and demographic factors.

Abstract

Background: Schizophrenia is a chronic mental health disorder significantly impacting the Quality of Life (QOL) of both patients and their family caregivers. In Romania, approximately 193,000 individuals are affected by schizophrenia, with most relying on non-professional family caregivers. These caregivers face substantial psychological, physical, financial, and social challenges, which remain understudied and often overlooked by health policymakers. This research employs a biopsychosocial framework to explore the interconnected clinical, cognitive, and sociocultural factors influencing the QOL of schizophrenia patients and their caregivers.

Objectives: This study aims to assess the QOL of schizophrenia patients and their family caregivers in a Romanian sample, focusing on key determinants such as social support, financial stressors, and caregiving burden, to provide insights for interventions and possibly policy development.

Methods: This cross-sectional study included 156 individuals: 52 schizophrenia patient-family caregiver pairs (n = 104) and a control group of 52 participants recruited from an occupational health clinic. The control group was matched with the patient-caregiver pairs on demographic characteristics, including age, gender, education, and socioeconomic status. Controls were selected to reflect similar socioeconomic and health-related challenges but excluded individuals with a history of mental health disorders. Schizophrenia diagnoses were established using ICD-10 criteria (F20.0-9). QOL was assessed using the Heinrichs-Carpenter Quality of Life Scale (QLS) exclusively for schizophrenia patients, while the WHOQOL-BREF was administered to all participants to ensure comparability. Additional assessments included the Beck Depression Inventory (BDI) for depressive symptoms, the Montreal Cognitive Assessment (MoCA) for cognitive functioning, the Eppendorf Schizophrenia Inventory (ESI) for caregiver psychopathology, and the Global Assessment of Functioning (GAF) scale to measure functional status.

Results: Caregivers exhibited elevated depressive symptoms, with a mean Beck Depression Inventory (BDI) score of 25 (≥20 indicates moderate depression), highlighting the significant psychological burden associated with caregiving. In contrast, the control group had a mean BDI score of 15, below the clinical threshold. Additionally, caregivers demonstrated reduced cognitive functioning, with a mean Montreal Cognitive Assessment (MoCA) score of 24, compared to 28 in the control group (<26 suggests mild cognitive impairment). These findings underscore the biopsychosocial stressors faced by caregivers.

Conclusions: This study highlights the significant cognitive, psychological, and sociocultural burdens associated with schizophrenia for patients and caregivers, advancing understanding of these challenges in a Romanian context. By emphasizing the need for integrated, culturally sensitive care models, our findings offer actionable insights to inform national and international mental health policies and future research on caregiver support and QOL enhancement.