Patients with schizophrenia often present sleep complaints, but its relationship with general satisfaction with life (SWL) and burden for caregivers has been understudied. We aimed to assess the differences in SWL between patients with and without self-reported sleep disturbances and that of their caregivers. In a noninterventional study, 811 schizophrenia adult outpatients were screened for their subjective perception of having (or not) sleep disturbances and evaluated with the Brief Psychiatric Rating Scale (BPRS) and the Pittsburgh Sleep Quality Index (PSQI). Patients self-reporting sleep disturbances were significantly more symptomatic ( ), presented significantly worse family support ( ), and self-reported worse SWL in all domains. Caregivers of patients with schizophrenia self-reporting sleep disturbances also reported worse SWL in all domains, as compared to caregivers of patients without subjective sleep disturbances. Patient and caregivers’ SWL was significantly correlated to patients’ quality of sleep ( for all domains). Patient’ and caregivers’ SWL was negatively affected by patients’ poor quality of sleep. We found that patients self-reporting sleep disturbances showed greater symptom severity, worse quality of sleep, worse SWL, and less caregiver support. SWL was also worse for caregivers of patients with schizophrenia reporting sleep disturbances. Patients with schizophrenia often present sleep complaints [1], even while being medicated and clinically stable, which can negatively affect their quality of life [2] and be sufficiently severe to warrant clinical attention. Nowadays, besides symptomatic control, the aim of clinicians is to improve schizophrenia patients’ social functioning, quality of life, and satisfaction with life (SWL). To accomplish this, physiologic sleep may be necessary. General SWL has been associated with symptoms, cognition, health-related quality of life, and medical comorbidity [3–5]. Higher burden has been reported for caregivers of schizophrenia patients with higher symptom severity, disruptive or difficult behavior, younger age, and patients’ need for care [6–10]. Given the importance of sleep in schizophrenia, we aimed to assess the differences in SWL between patients with and without self-reported sleep disturbances and that of their caregivers, as well as the degree of family support, since we found no previous reports on this subject. In a multicenter, Iberian, cross-sectional, noninterventional study, 811 outpatients with a diagnosis of schizophrenia, aged ≥18 years, and with no changes in antipsychotic
References
[1]
J. M. Monti, A. S. Bahammam, S. R. Pandi-Perumal, et al., “Sleep and circadian rhythm dysregulation in schizophrenia,” Progress in Neuropsychopharmacology and Biological Psychiatry, vol. 3, no. 43, pp. 209–216, 2013.
[2]
P. Afonso, S. Brissos, M. L. Figueira, and T. Paiva, “Schizophrenia patients with predominantly positive symptoms have more disturbed sleep-wake cycles measured by actigraphy,” Psychiatry Research, vol. 189, no. 1, pp. 62–66, 2011.
[3]
M. S. Ritsner, A. Lisker, and M. Arbitman, “Ten-year quality of life outcomes among patients with schizophrenia and schizoaffective disorders: I. Predictive value of disorder-related factors,” Quality of Life Research, vol. 21, no. 5, pp. 837–847, 2012.
[4]
M. Lambert, B. G. Schimmelmann, A. Schacht et al., “Long-term patterns of subjective wellbeing in schizophrenia: cluster, predictors of cluster affiliation, and their relation to recovery criteria in 2842 patients followed over 3 years,” Schizophrenia Research, vol. 107, no. 2-3, pp. 165–172, 2009.
[5]
M. M. Kurtz, M. Bronfeld, and J. Rose, “Cognitive and social cognitive predictors of change in objective versus subjective quality-of-life in rehabilitation for schizophrenia,” Psychiatry Research, vol. 200, no. 2-3, pp. 102–107, 2012.
[6]
M. A. Zahid and J. U. Ohaeri, “Relationship of family caregiver burden with quality of care and psychopathology in a sample of Arab subjects with schizophrenia,” BMC Psychiatry, vol. 10, no. 10, p. 71, 2010.
[7]
H. R. Winefield and E. J. Harvey, “Determinants of psychological distress in relatives of people with chronic schizophrenia,” Schizophrenia Bulletin, vol. 19, no. 3, pp. 619–625, 1993.
[8]
A. Caqueo-Urízar, J. Gutiérrez-Maldonado, and C. Miranda-Castillo, “Quality of life in caregivers of patients with schizophrenia: a literature review,” Health and Quality of Life Outcomes, vol. 7, no. 7, p. 84, 2009.
[9]
D. A. Perlick, R. A. Rosenheck, R. Kaczynski, M. S. Swartz, J. M. Ca？ive, and J. A. Lieberman, “Components and correlates of family burden in schizophrenia,” Psychiatric Services, vol. 57, no. 8, pp. 1117–1125, 2006.
[10]
C. Roick, D. Heider, M. Toumi, and M. C. Angermeyer, “The impact of caregivers' characteristics, patients' conditions and regional differences on family burden in schizophrenia: a longitudinal analysis,” Acta Psychiatrica Scandinavica, vol. 114, no. 5, pp. 363–374, 2006.
[11]
P. Afonso, S. Brissos, F. Ca？as, J. Bobes, I. Bernardo-Fernandez, et al., “Treatment adherence and quality of sleep of schizophrenia outpatients,” International Journal of Psychiatry in Clinical Practice. In press.
[12]
C. Roick, D. Heider, and P. E. Bebbington, “Burden on caregivers of people with schizophrenia: comparison between Germany and Britain,” British Journal of Psychiatry, vol. 190, pp. 333–338, 2007.
