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Functioning and Well-Being of Middle-Aged and Older Patients With Schizophrenia

Measurement With the 36-Item Short-Form (SF-36) Health Survey

Received June 4, 2003; revised August 19, 2003; accepted September 15, 2003. From the Department of Psychiatry, University of California, San Diego, Veterans Affairs San Diego Healthcare System. Send correspondence to Thomas L. Patterson, Ph.D., Professor of Psychiatry, Department of Psychiatry, University of California, San Diego, San Diego, CA 92093-0680. e-mail: tpatterson{at}ucsd.edu

Objective: The authors compared the subjective functioning of 137 middle-aged and elderly outpatients with schizophrenia or schizoaffective disorder with that of 77 normal subjects, using the Medical Outcomes Study (MOS) 36-Item Short Form (SF-36) Health Survey. The SF-36 is a generic outcome measure that provides a profile of functioning in several different domains. Methods: Measures included the MOS-SF-36, along with standardized instruments for assessing psychopathology, cognition, dyskinesia, quality of well-being, and everyday functioning. Results: Schizophrenia patients reported greater disability than normal subjects in all areas (mental and physical) assessed by the SF-36 except for bodily pain. Logistic-regression analysis suggested that the best predictors for being in the schizophrenia group were 1) physical and emotional functioning and 2) pain. Among patients, age at onset of illness, depressive symptoms, and cognitive functioning predicted 39% of the variance in the SF-36 Mental Health Composite score. Conclusions: Subjective functioning of older people with schizophrenia is affected by perceived physical health, depressive symptoms, and cognitive impairment.

Key Words: Schizophrenia • Diagnostic Tests • Functional Status