Attachment Styles, Quality of Life and Service Satisfaction Outcomes in People with Schizophrenia in Israel

Aim: To test the hypothesized associations among satisfaction with psychiatric rehabilitation services, health-related quality of life (HRQoL), psychopathology and attachment styles in inpatients with schizophrenia. Methods: One hundred-one patients with International Classification on Diseases, Tenth Edition (ICD-10) diagnosis of schizophrenia and duration of rehabilitation program no less than six months were recruited from the rehabilitation wards of the Sha'ar Menashe Mental Health Center, Hadera, Israel. The outcome variablesandattachment styleswere assessed with the standardized questionnaires, and psychopathology severity with the Positive and Negative Syndrome Scale (PANSS). Univariate and multivariate analyses were performed to examine the study hypotheses. Results: Attachment anxiety, dissatisfaction with rehabilitation services and the severity of general psychopathology predicted poorer HRQoL, accounting for 8.7%, 13.9%, and 5.4%, respectively, of the total variance(R2=.30; Adjusted R2=0.26; F4,100=7.98, p<0.001). In turn, the HRQoL was the only predictor of service satisfaction, accounting for 17% of the variance (R2=.17; Adjusted R2=0.13; F4,101=3.95, p=<0.01). Conclusion: The results confirmed the hypothesized association between HRQoL and satisfaction with rehabilitation services. Despite this relation, attachment anxiety predicted only poorer HRQoL and more severe general psychopathology, but not service dissatisfaction. The results could contribute to the development of innovative rehabilitation strategies to improve both HRQoL and service satisfaction among inpatients with schizophrenia.