Perceived satisfaction with care, service atmosphere and mood fluctuations among patients with schizophrenia spectrum disorder in Italian mental health supported accommodations: a multicenter study

Background Supported Accommodations (SA) are central to Italy’s community-based mental health care for individuals with schizophrenia spectrum disorders (SSD), offering structured, recovery-oriented environments. While symptom severity remains important, care environment and satisfaction strongly influence well-being. Mood fluctuations, a key aspect of daily functioning, have been underexplored in SA. Using the Experience Sampling Method (ESM), this study aims to examine the associations between perceived ward atmosphere, care satisfaction, and momentary mood in SA residents with SSD. Methods As part of the DiAPAson project, 68 residents with SSD were assessed also using ESM. Additional measures included psychopathology (BPRS, BNSS), functioning (SLOF, WHODAS 2.0), perceived ward atmosphere (WAS-P) and service satisfaction (VSSS-32). Descriptive analyses were conducted, and a structural equation model examined mood in relation to clinical, demographic, and environmental factors. Results Residents with SSD (29.4% female; mean age = 42.8 years) were mostly single (80.9%) and unemployed (79.4%), with a mean disorder duration of 19.2 years. Clinical assessments indicated moderate symptom severity and functioning. Structural equation modelling showed excellent fit (CFI = 1.000; RMSEA = 0.000; SRMR = 0.060). The latent variable Env-Perc, combining service satisfaction (VSSS-32) and perceived ward atmosphere (WAS-P), was the only significant predictor of momentary mood (β = 0.344, 95%CI: [0.084;0954], p = 0.033). Conclusions Perceived satisfaction with care and service atmosphere in SA contribute to promoting positive mood among individuals with SSD. Trial registration ISRCTN registry ID ISRCTN21141466, registration date 17 February 2020.