Quality of Life in Schizophrenia Patients: Challenges and Practical Approaches to Care

Announcer:
Welcome to On the Frontlines of Schizophrenia on ReachMD. On this episode, we’ll hear from Ms. Desiree Matthews, who’s a board-certified psychiatric nurse practitioner and the Clinical Director of Different MHP in Charlotte, North Carolina. She’ll be discussing how we can improve quality of life for patients with schizophrenia. Let’s hear from Ms. Matthews now.

Ms. Matthews:
Schizophrenia is one of the diagnoses that is very challenging when it comes to the decrease in quality of life that these individuals live with every day. We know that schizophrenia and the symptoms can impact and disrupt all facets of life, including personal, social, health-related, quality of life, and just their independence of living on their own and working.

We know that research shows that individuals living with schizophrenia tend to be more sedentary. We think this could be one of the reasons why we see high rates of metabolic disease heart disease, obesity, and cancer, unfortunately. We know some of our medications that we use to treat schizophrenia can also come with an increased burden on metabolic dysfunction. On average, individuals with schizophrenia die 30 years earlier, and what’s startling about this is the fact that this has actually gotten worse over time rather than better. So when we think about medications, using medications that have the least amount of side effects, especially metabolically, and looking at ways to potentially help them get up and moving can address the medical comorbidities that these individuals live with.

We also know that cognitive impairment is very common. Upwards of 80 percent or more of individuals with schizophrenia live with some type of cognitive impairment, and this can make it hard to work, finish school, or even remember to take medications or get to the doctor on time. So with all of this, we know that on average, individuals get schizophrenia diagnoses in their 20s or 30s. If you’re female, it could be a little bit later, but oftentimes, this is right when people are trying to go to school, graduating, or getting married. So it can really disrupt not only the individual in their trajectory, but also their family or potentially even their children. 

And with these challenges of quality of life, unfortunately, there is not quick fix to this. I really wish there was. But at this point, in my clinical practice, creating treatment plans to improve the quality of life is very person centered and very specific to each individual. I really come at this as a holistic approach in terms of supporting individuals and their families. Things like using medications with the least amount of side effects, helping individuals stay adherent to treatment by utilizing long-acting injectables, for instance, and really addressing nutrition, physical activity, and helping increase social skills, are key pillars in how I address schizophrenia.

Unfortunately, as I mentioned, there’s not one treatment that will improve quality of life. However, we do have some evidence that shows that reducing relapses of schizophrenia in particular can help with reducing the functional decline that we see in individuals that, of course, relate to quality of life and also reduce the risk of mortality. So addressing both the physical and mental health components of schizophrenia are key priorities in my clinical practice. 

One of the problems we find in society is, unfortunately, the stigma surrounding schizophrenia. And this really can hurt everybody, including the individual, of course, living with those symptoms because they may be less likely to actually come and seek out treatment. We have a lot of misinformation and stigma. In general, the public often learns about schizophrenia as it’s portrayed in like movies or TV, and that can be very inaccurate. We know just talking about schizophrenia and providing public education to help destigmatize the condition can really help. That way, family, friends, and individuals living with schizophrenia are more apt to seek out appropriate treatment.

Announcer:
That was Ms. Desiree Matthews discussing quality of life challenges among patients with schizophrenia. To access this and other episodes in our series, visit On the Frontlines of Schizophrenia on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!