Published: 2021-05-27

Study of the difference in quality of life and caregiver burden among patients with schizophrenia and rheumatoid arthritis

Shaista Shaban, Mohd Abrar Ahmad Guroo, Racheal Bashir


Background: Quality of life (QOL) is a measure to see an individual’s adaptation and feeling of wellbeing and adjustment with the surroundings. Schizophrenia and rheumatoid arthritis (RA) both are chronic and disabling disorders supposed to have significant effect on quality of life. Also chronicity and disability of these disorders can be directly proportional to the caregiver burden.

Methods: Comparative study assessing quality of life and caregiver burden between persons with schizophrenia and RA.

Results: 50% of the schizophrenia group as well as the RA group were unemployed, suggesting the magnitude of the disability levels caused by the illness. Only 33% of patients with schizophrenia were married, unlike patients with RA where 83% were married. Of all the four domains of the World Health Organization quality of life instrument (WHO-QOL BREF) both the groups scored highest in the physical domain and least in the psychological domain and the difference between the two groups was not statistically significant in all the four domains. Burden among the caregivers of schizophrenic patients was comparatively high on BAS than caregivers of rheumatoid arthritis. The mean duration of illness in patients with schizophrenia was significantly higher than patients with RA.

Conclusions: RA is a chronic disorder and physical in nature with full insight in the patients. While as schizophrenia is characterized as a chronic mental illness with poor prognosis and no insight. QOL is expected to be less in schizophrenic patients. There is no significant difference in QOL except in physical domain in which patients with schizophrenia scored significantly better than patients with RA. The social domain of QOL was the only one in which schizophrenic patients did poorly, though not statistically significant. Also care giver burden was more among caregivers of schizophrenic patients and that can be attributed to lack of insight.


Rheumatoid arthritis, Quality of life, Schizophrenia, Care giver burden

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Skevington SM, Lotfy M, O’Connell KA. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL Group. Qual Life Res. 2004;13:299-310.

Gibofsky A. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. Am J Manag Care. 2012;(13):295-302.

Fassbender HG. The clinical presentation of rheumatoid arthritis: the results from three separate pathogenetic mechanisms in adults and children. Acta Clin Croat. 2008;47(1):50-5.

Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Out. 2009;7:25.

World Health Organization, Burden of Mental and Behavioral Disorders, The World Health: New understanding, New Hope; Geneva, World Health Organization. 2001. Available at: Accessed on 21 January 2021.

Norman RM, Malla AK, McLean T, Voruganti LP, Cortese L: The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale. Acta Psychiatr Scand. 2000;102:303-9.

Functional limitations and quality of life in schizophrenia and other psychotic disorders, National Institute for Health and Welfare, Mental Health and substance Abuse Services, Helsinki, Finland. 2009.

Current Issues in Schizophrenia: Overview of Patient Acceptability, Functioning Capacity and Quality of Life. Lambert, Martin; Naber, Dieter. CNS Drugs. 2004;18:5-17.

WHOQOL-BREF. Introduction, administration, scoring and generic version of the assessment. Field Trial Version. Programme in mental health world health organisation. Geneva. 1996. Available at: Accessed on 21 January 2021.

Thara R, Padmavati R, Kumar S, Srinivasan L. Instrument to assess burden on caregivers of chronic mentally ill. Indian J Psychiatr. 1998;40(1):21-9.

Ochoa S, Usall J, Cobo J, Labad X, Kulkarni J. Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophr Res Treatment. 2012;916198.

Intriago M, Maldonado G, Cárdenas J, Ríos C. Clinical Characteristics in Patients with Rheumatoid Arthritis: Differences between Genders. Scientific World J. 2019;8103812.

Schuntermann MF. Die internationale Klassifikation der Impairments, Disabilities und Handicaps ICIDH--Ergebnisse und Probleme [International Classification of Impairments, Disabilities and Handicaps ICIDH--results and problems]. Rehabilitation (Stuttg). 1996;35(1):6-13.

Persons with disabilities Equal opportunities, protection of rights and full participation. 2010. Available at: 48618833/. Accessed on 21 January 2021.

Galuppi A, Turola MC, Nanni MG, Mazzoni P, Grassi L. Schizophrenia and quality of life: how important are symptoms and functioning. Int J Ment Health Syst. 2010;4:31.

Radhakrishnan R, Menon J, Kanigere M, Ashok M, Shobha V, Galgali RB, et al. Domains and determinants of quality of life in schizophrenia and systemic lupus erythematosus. Indian J Psychol Med. 2012;34:49-55.

Hasanah CI, Razali MS. Quality of life: An assessment of the state of psychosocial rehabilitation of patients with schizophrenia in the community. J R Soc Promot Health. 2002;122:51-5.

Giel R, de Arango MV, Hafeiz Babikir A, Bonifacio M, Climent CE, Harding TW, et al. The burden of mental illness on the family. Results of observations in four developing countries. A report from the WHO Collaborative Study on Strategies for Extending Mental Health Care. Acta Psychiatr Scand. 1983;68(3):186-201.

Beckham JC, Burker EJ, Rice JR, Talton SL. Patient predictors of caregiver burden, optimism, and pessimism in rheumatoid arthritis. Behav Med. 1995;20:171-8.