Department of Experimental Psychology, University of Seville, Sevilla, Spain.
Psychol Psychother. 2023 Jun;96(2):525-541. doi: 10.1111/papt.12451. Epub 2023 Feb 14.
When considering the personal recovery of people with serious mental illness (SMI), it is essential to examine their reported psychiatric distress and quality of life (QoL). However, there is no consolidated model in the literature that clearly relates these variables. In this study we first analysed the relationships between QoL, psychiatric distress and recovery, and several sociodemographic variables. Second, we analysed the linear effects of psychiatric distress and recovery on QoL. Third, and most important, we tested two hypotheses that considered personal recovery as a moderator or mediator of the relationship between psychiatric distress and QoL.
234 volunteers with a diagnosis of SMI completed three self-report questionnaires, The Recovery Assessment Scale-24, The World Health Organization QoL and the Clinical Outcomes in Routine Evaluation-Outcome Measure, which showed very good levels of validity and reliability. The PROCESS macro for SPSS developed by Hayes (Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guilford Press, 2022) was applied using the Bootstrap method to verify our moderation and mediation hypotheses.
We found a negative linear effect of psychiatric distress on QoL, as well as a positive effect of recovery on said variable. Our results do not confirm the moderating effect of recovery on the relationship between distress and QoL. However, we do confirm the second hypothesis; recovery functioned as a mediating variable between psychiatric distress and QoL.
These findings allow us to reflect on how personal recovery affect the relationship between psychiatric distress and QoL and discuss its theoretical and practical implications as public policies.
在考虑严重精神疾病（SMI）患者的个人康复时，检查他们报告的精神困扰和生活质量（QoL）至关重要。然而，文献中没有一个明确的综合模型将这些变量联系起来。在这项研究中，我们首先分析了 QoL、精神困扰和康复与几个社会人口学变量之间的关系。其次，我们分析了精神困扰和康复对 QoL 的线性影响。第三，也是最重要的，我们检验了两个假设，即认为个人康复是精神困扰和 QoL 之间关系的调节者或中介者。
234 名被诊断为 SMI 的志愿者完成了三份自我报告问卷，即康复评估量表-24、世界卫生组织生活质量量表和临床结果常规评估-结果测量量表，这些问卷显示出非常好的效度和信度水平。我们应用了由 Hayes 为 SPSS 开发的 PROCESS 宏（《中介、调节和条件过程分析导论：基于回归的方法》，The Guilford Press，2022 年），使用 Bootstrap 方法验证了我们的调节和中介假设。
我们发现精神困扰对 QoL 有负向的线性影响，而康复对 QoL 有正向影响。我们的结果不确认康复对困扰和 QoL 之间关系的调节作用。然而，我们确实确认了第二个假设；康复是精神困扰和 QoL 之间的中介变量。
这些发现使我们能够反思个人康复如何影响精神困扰和 QoL 之间的关系，并讨论其作为公共政策的理论和实践意义。
