Happiness Can Be Part of Life for People With Schizophrenia

Having schizophrenia brings a host of daunting problems, but it does not preclude happiness, concluded researchers at the University of California, San Diego (UCSD).

As one might expect, compared with 64 healthy control subjects, 72 outpatients with nonremitted chronic schizophrenia were not as happy as measured with four items of the Center for Epidemiologic Studies Depression Scale, which the researchers used as a scale to measure happiness (CESD-H). But that didn’t mean that all of the schizophrenia subjects were unhappy.

“[T]here was considerable heterogeneity in levels of happiness among people with schizophrenia,” reported lead author Barton Palmer, Ph.D., a professor in UCSD’s Department of Psychiatry, and colleagues online August 14 in Schizophrenia Research.

In fact, 37.5 percent of the people with schizophrenia had CESD-H scores in the upper third of the range, as did 82.8 percent of the controls. Another 15.3 percent had scores in the lowest third of the range, while none of the controls’ scores were that low.

There were no significant correlations in the group with schizophrenia between levels of happiness and positive, negative, or anxiety symptoms, or between happiness and physical health or cognitive functioning, the researchers said. Nor was happiness correlated with age, education, or duration of illness.

Happier people with schizophrenia did have lower perceived stress, higher levels of trait and event resilience, optimism, and personal mastery.

In short, “happiness is affected by, but not incompatible with, chronic schizophrenia and is strongly correlated with a number of positive psychosocial traits or factors,” they wrote.

So if more than 1 in 3 people with a highly heritable illness like schizophrenia say they are happy, then perhaps “happiness may be a viable goal for many individuals with this disorder,” said Palmer and colleagues. “An important follow-up question is whether happiness among people with schizophrenia can be improved through intervention.”

Such interventions might include techniques like cognitive reframing, grateful thinking, and mindfulness training, they noted.

“People with schizophrenia are clearly less happy than those in the general population at large, but this is not surprising,” said Palmer. “What is impressive is that almost 40 percent of these patients are reporting happiness and that their happiness is associated with positive psychosocial attributes that can be potentially enhanced.”

“People tend to think that happiness in schizophrenia is an oxymoron,” said study co-author and former APA President Dilip Jeste, M.D., a professor of psychiatry and neurosciences and the Estelle and Edgar Levi Chair in Aging at UCSD, in a statement. “Without discounting the suffering this disease inflicts on people, our study shows that happiness is an attainable goal for at least some schizophrenia patients. This means we can help make these individuals’ lives happier.”

The research was funded, in part, by the National Institute of Mental Health and the Center for Healthy Aging and the Sam and Rose Stein Institute for Research on Aging at UCSD. ■