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This research aims to identify predictors of subjective quality of life improvement among patients with schizophrenia in rehabilitation programs.

April 3, 2026Open Access

Predictors for quality of life improvement in schizophrenia: a prospective study of patients in hospital-based rehabilitation programs

Key Points

This research aims to identify predictors of subjective quality of life improvement among patients with schizophrenia in rehabilitation programs.
Conducted a 24-week structured rehabilitation program with 235 patients diagnosed with schizophrenia.
Assessed subjective quality of life using the Schizophrenia Quality of Life Scale and clinical symptoms using multiple psychiatric scales.
Performed multiple regression analysis to evaluate associations between baseline and changes in symptoms and quality of life outcomes.
72.8% of patients showed significant quality of life improvement post-rehabilitation.
Negative associations identified with baseline psychiatric symptoms and depressive symptoms.
Positive associations noted with changes in negative symptoms and baseline psychosocial subdomain scores.

Abstract

Enhancing quality of life (QoL) is a crucial goal in the rehabilitation of patients with schizophrenia (SCZ). Identifying factors associated with the outcomes of rehabilitation is of clinical importance. This study examined predictors of subjective QoL (SQoL) outcomes in SCZ patients undergoing a structured 24-week rehabilitation program. A total of 235 patients with SCZ completed the program. SQoL was assessed using the Schizophrenia Quality of Life Scale (SQLS), comprising three subdomains: psychosocial (PS), motivation/ energy (ME), and symptoms/side effects (SS). Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7). Cognitive impairment was assessed using the Ascertain Dementia 8 (AD8). Medication side effects were assessed using the Treatment Emergent Symptom Scale and Rating Scale for Extrapyramidal Side Effects. After 24 weeks, the response rate (≥ 20% reduction of SQLS total score post-training from baseline was 72.8% (171/235). Multiple regression analysis revealed that SQoL improvement was negatively associated with baseline scores of BPRS negative symptoms (P = 0.017) and PHQ-9 (P = 0.034), while positively associated with changes in BPRS negative symptoms (P = 0.031) and PHQ-9 (P = 0.034), and baseline PS subdomain (P = 0.021). The predictive model yielded an area under the curve of 0.798, which increased to 0.926 when changes in clinical symptoms were included. Structured rehabilitation training may significantly improve SQoL in patients with SCZ. Both baseline levels and changes in psychiatric symptoms, cognition, anxiety, and baseline PS subdomain levels significantly predict SQLS improvement, suggesting they could be targets for future comprehensive and individualized interventions. This protocol was registered on February 21, 2021, at chictr.org.cn (Identifier: ChiCTR2100043537).

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