Original Article

Visual Disability

Improving Quality of Life using Group Therapy among Patients

with Schizophrenia
1 2 3
Vishmita, Amool Ranjan Singh, Prem Prakash
1
Ph. D Scholar, Department of Psychiatric Social Work, Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi.
2
Professor, Department of Psychology, Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi.
3
Ph. D Scholar, Department of Psychiatric Social Work, Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi.

ABSTRACT

Background: In this study, we assessed that the group therapy improved quality of life in patients with schizophrenia.
This study was conducted at Psychiatric In-patient unit of Ranchi Institute of Neuro-Psychiatry and Allied Sciences
(RINPAS). Objective: This study was conducted to evaluate the role of group therapy on different outcome variables in
schizophrenia patients. Sample: The sample was consisted of 20 patients with schizophrenia selected from in patient
department of Ranchi Institute of Neuro-Psychiatry and Allied Sciences for the current study. Among the total
numbers of the patients, 10 were randomly assigned for group therapy with treatment as usual (GT+TAU)
(experimental group) and 10 of them were assigned treatment as usual (TAU) (control group). Design: It was hospital-
based intervention study. In this study pre and post- test design with control group in which schizophrenia patients
assigned randomly in experimental and control group. Tools: Socio-Demographic & Clinical Data Sheet and
WHOQOL-BREF scale were used for the assessment. After completion of the therapy sessions, post assessment was
done and the follow up assessment completed after three months of post assessment. The Statistical Package for
Social Sciences (SPSS) 20.0 for windows was used for statistical analysis with the help of Mann-Whitney U test,
Wilcoxon Sign Rank test and Chi-square test. Results: Result of the present study reveals that there were statistical
significant differences in the scores of different domains of Quality of life between experimental and control group
Conclusions: The overall this study confirmed the hypotheses and prove that patients with schizophrenia benefit from
group therapy in improving Quality of life and it was also show that the therapeutic gains were retained with no
substantial degradation over a considerable period of time showing the durability and effectiveness of the group
therapy used in the study.

Keywords: Group therapy, Quality of life and Schizophrenia.

INTRODUCTION Organization as “Individuals' perceptions of their

position in life in the context of the culture and value
Schizophrenia has been categorized as one of the most
systems in which they live, and in relation to their goals,
serious and disabling mental disorders. The lifetime
expectations, standards, and concerns.”QOL has
prevalence of schizophrenia is estimated to be about 1%
primarily focused on the impact of psychiatric
worldwide (Mueser& McGurk, 2004). Group therapy
symptoms. In recent years, several research groups have
may have so many therapeutic advantages for the
concluded that the so-called negative symptoms of
patient of schizophrenia. After implication of therapy
schizophrenia are much more closely related to quality
Group patients show improvement in social
of life than positive symptoms (Overall & Gorham, 1962;
functioning, quality of life, self-esteem etc.
Galletly et al. 1997). In a study of 128 patients, Norman et
Quality of life is defined by the World Health al. (2000) have examined the relationship of symptoms
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Journal of Disability Management and Rehabilitation 4(1), 2018
Vishmita et al
and level of functioning in schizophrenia to the quality
of life: their results show that negative symptoms, level
of functioning and positive symptoms all were related to
the Quality of Life Scale. Schizophrenia is a disease that
can devastate the lives of people who suffer from it, and
people with it suffer distress, disability, reduced
productivity, and lowered quality of life (QOL).
Recently, there has been increasing interest in QOL of
people with schizophrenia, and now, QOL measures are
included routinely in most studies of intervention or
outcome (Fitzgerald et al. 2001; Taniguchi et al. 2006).
QOL of people with schizophrenia has been measured
from two different viewpoints. One is a self rated
measurement of QOL (subjective QOL) and the other is
an interviewer-rated measurement of QOL (objective
QOL). Although, according the definition by the World
Health Organization, individuals' perception of QOL
seems to be vital, QOL of schizophrenia patients had
been frequently assessed with objective QOL measures.
Because of schizophrenia patients' cognitive
impairment, they had been thought to be unable to
evaluate their own QOL by themselves.
However, nowadays, there is general agreement that
stabilized schizophrenia patients could assess their
QOL by themselves (Voruganti et al., 1998). Objective
measures of QOL usually include indicators of
health and living conditions, socio demographic items
and role functioning in society, whereas subjective
measures of QOL do indicators of life satisfaction in
general and within different life domains (Fitzgerald et
al. 2001).
A quality of life assessment can help identify where a
patient has problems or difficulties. In the case of long-
term illness such as schizophrenia, overcoming any of
these difficulties may make the patient feel healthier,
and as a result make fewer demands on health services
(Orley, Saxena & Herrman, 1998).
METHOD
Sample:
After various inclusion and exclusion criterions sample
were selected from the inpatient departments of
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Journal of Disability Management and Rehabilitation 4(1), 2018
RINPAS, Kanke, Ranchi, Jharkhand through random
sampling technique 24 patients were selected for group
therapy. In due course of time, as four patients in which
two were not co-operative for training and two were pre
maturely discharged from the hospital on care-givers
request hence final analysis was done with only 20
patients and duration of their illness is less than 2 years.
Both groups were matched in the socio-demographic
characteristics and clinical variables. Patients were in the
age range of 25 to 35 years.
Design:
A pre test and post test design with control group was
used in this study. Equal numbers of patients were
randomly assigned to Experimental and Control group.
Tool:
Socio-Demographic & Clinical Data Sheet: It is semi-
structured, self-prepared Performa especially drafted
for this study. It was consisted of all areas of socio-
demographic details like age, sex, domicile, education,
employment, marital status etc., and questions related to
nature of illness, substance dependence, co-morbid
psychiatric disorder, age of onset of illness, duration of
illness, hearing & visual impairment and severe physical
illness in the near past.
Quality of Life Scale (WHOQOL-BREF., Hindi version):
Hindi version of the WHOQOL-BREF has been derived
from the original World Health Organization Quality of
Life Scale. The Hindi version WHOQOL-Bref Scale is
adopted by Saxena et al. (1998). WHOQOL-BREF is a
short version of WHOQOL-100 questionnaires.
WHOQOL-BREF has been tested in 15 centers including
New Delhi and Chennai from India. WHOQOL-BREF
contains 26 questions in 4 major domains (i.e. physical
health, psychological health, social relationships and
environment) to measure the quality of life. This scale
emphasizes subjective experiences of the respondents
rather than their objective life conditions. The alpha
score of all domain ranges from 0.59 to 0.87, Cronach
alpha of the all domains are 0.87, the factor loadings of
the item ranges 0.52 to 0.84 WHOQOL-BREF is highly
valid version across cultures.
1
 Improving Quality of life using Group therapy among Patients with Schizophrenia

Procedure: Statistical Analysis:

Patients were selected from different in patients
psychiatric unit as per the inclusion and exclusion
criterions. Sample was selected to the experimental and
control group according to the sample recruitment
procedure. Socio-demographic data was collected from
this patients. After that quality of life scale was
administered to both the groups. 10 patients of group
were involved in group therapy for approximately 12
sessions of weekly twice- thrice for about 60-90 minutes'
duration. The second group was control group and
asked to follow routine work. After the intervention both
the group was administered again with quality of life
scale. Both groups were assessed on different outcome
variable first before beginning of the therapy, second
after six weeks and then lastly after three months of post
assessment.
Table 1
Comparison between Experimental and Control Group on Socio-Demographic Variable (Category Variables)
As sample size in this study was small, hence obtained
data was analyzed by using non–parametric statistics,
namely, Chi- square test, Mann Whitney U test (for
between group comparison) and Wilcoxon Sign Rank
Test (for within group comparison).
RESULTS
Table 1 shows the comparison of two groups, i.e.
experimental group difference found on any socio-
demographic parameters and Control Group in relation
to socio- domicile, education, occupation, religion and
family Income. Demographic parameters. These two
groups had not significant difference found on any
socio- demographic parameters i.e. domicile, education,
occupation, religion and family income.

Variable Group N=20

Experimental Control Df χ2
Group Group

(N=10) (%) (N=10) (%)

Rural (10)100% 7(70%) 1 3.529(NS)

Domicile Urban 3 (30%)

Marital Married (5) 50% (5) 50% 1 0.000(NS)

status Unmarried (5) 50% (5) 50%

Education Below matric (5) 50% (3) 30%

Matric (2) 20% (1) 10% 2 1.833(NS)

Above matric (3) 30% (6) 60%

Occupation employed (7) 70% (7) 70% 1 .000 (NS)

unemployed (3) 30% (3) 30%

Religion Hindu (9) 90% (9) 90% 1 .000 (NS)

Islam (1) 10% (1) 10%

Family Below 5000 (1) 10% (2) 20% 2 .400(NS)

income 5000-10000 (8) 80% (7) 70%

10000-20000 (1) 10% (1)10%

NS= Not Significant

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Table 2
Comparison between Experimental and Control group at baseline on WHO-QOL BREF scores.

Variable Group (Mean ± SD) Mean Rank U Z

Experimental Control Experimental Control

Group Group Group Group

WHO Quality of life

Physical 10.80±1.39 9.60±1.42 12.70 8.30 31.50 -1.71(NS)

Health

Psychological 10.40±1.34 10.70±1.88 10.15 10.85 27.00 -0.27(NS)

Health

Social 10.30±1.41 9.90±1.44 11.30 9.70 41.50 -0.62(NS)

Relationship

Environment 10.90±2.60 10.20±2.20 11.35 09.65 35.00 -0.65(NS)

NS= Not Significant

Table 3
Comparison between group and Control group on WHOQOL-BREF scores at post intervention phase.

Variable Group (Mean ± SD) Mean Rank U Z

Experimental Control Experimental Control

Group Group Group Group

Post Assessment

Physical 14.00±2.66 12.50±1.50 13.00 8.00 25.00 -1.920 **

Health

Psychological 14.30±1.63 12.40±1.34 13.65 7.35 18.50 -2.437 **

Health

Social 13.80±1.98 11.50±1.26 13.80 7.20 17.00 -2.524 **

Relationship

Environment 15.30±1.88 12.80±2.57 13.30 7.70 22.00 -2.163 **

*p<0.05, **p<0.01, ***p<0.001

Table 2 shows the comparison of the scores on the
different domains of WHOQOL- BREF between
Experimental and control Group which was done using
Mann-Whitney U Test. It was found that the mean value
for Physical Health was 10.80±1.39 for Experimental
group and 9.60±1.42 for the control group. There was no
significant difference between the two groups on this
domain of WHOQOL- BREF (Z=1.71, p>0.05). Similarly,
the mean value for Psychological Health was 10.40±1.34
for Experimental and 10.70±1.88 for Control group
respectively. The difference between the two groups on
this domain was also not significant (Z=0.272 p>0.05).
This finding also indicates that there was no significant
difference between the Experimental and Control group

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Journal of Disability Management and Rehabilitation 4(1), 2018
 Improving Quality of life using Group therapy among Patients with Schizophrenia

in respect to this domain. The mean value for Social
Relationship was 10.30±1.41 of Experimental group and
9.90±1.44 of the control group. There was no significant
difference between the two groups (Z=0.621, p>0.05)
which suggests that there was no significant difference
between the two groups in respect to this domain. The
mean score for Environment was 10.90±2.60 and
10.20±2.20 of both the groups respectively. The
difference between these two groups was also not
significant (Z=0.655, p>0.05) suggesting no significant
difference between these two groups on this domain of
WHOQOL- BREF.
Table 3 shows the comparison of the scores on the
different domains of WHOQOL- BREF between
Experimental and Control Group which was done using
Mann-Whitney U Test. After analysis, it was found that
the mean value for Physical Health was 14.000±2.66 for
the Experimental group and 12.50±1.50 for Control
group. There was significant difference found between
the two groups on this domain of Physical Health
(Z=1.92, p<0.01). Similarly, the mean value for
Psychological Health was 14.30±1.63 and 12.40±1.34 for
the Experimental and Control group respectively. The
difference between the two groups on this domain was
also found significant (Z=2.43, p<0.01). This finding also
indicates that there was significant difference between
Experimental and Control group in respect to this
domain of Psychological Health. The mean value for
Social Relationship was 13.80±1.98 of the Experimental
group and 11.50±01.26 of the control group. There was
significant difference found between both the groups
(Z=2.54, p<0.01) which suggests that there was
significant difference between the two groups in respect
to this domain of social relationship. The mean value for
Environment was 15.30±1.88 and 12.80±2.57 of both the
groups respectively. The difference between these two
groups was also found significant (Z=2.16, p<0.01)
suggesting significant difference between these two
groups on this domain of environment. On this test,
higher score shows better Quality of life; hence,
Experimental group was better in comparison to Control
group on the domains of WHOQOL- BREF.
Table 4 shows the comparison of the scores on the
different domains of WHOQOL- BREF between
Experimental and Control group which was done using
Mann-Whitney U Test. After analysis, it was found that
the mean value for Physical Health was 15.20±1.13 for
the Experimental group and 12.60±1.26 for Control
group. There was significant difference found between
the two groups on this domain of Physical Health

Table 4
Comparison between Experimental group and Control group at follow-up on WHOQOL-BREF scores:

Group (Mean ± SD) Mean Rank

Variable Experimental Control Experimental Control U Z

Group Group Group Group

Follow up Assessment

Physical 15.20±1.13 12.60±1.26 14.95 6.05 5.50 -3.413**

Health

Psychological 15.40±1.83 13.50±1.26 17.55 7.45 19.50 -2.340*

Health

Social 14.20±1.22 12.20±1.39 14.15 6.85 13.50 -2.822**

Relationship

Environment 15.80±2.25 13.40±1.42 13.60 7.40 19.00 -2.392*

*p<0.05, **p<0.01, ***p<0.001

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Journal of Disability Management and Rehabilitation 4(1), 2018
Vishmita et al

(Z=3.41, p<0.01). Indicating that the experimental group groups on this domain of environment and maintained it
improvement was better to control group on this at follow-up assessment phase on this domain
domain. Similarly, the mean value for Psychological Experimental group was better in comparison to Control
Health was 15.40±1.83 and 13.50±1.26 for the group on the domains of WHOQOL- BREF in
Experimental and Control group respectively. The comparison to control group.
difference between the two groups on this domain was
Table 5 shows the comparison between the pre and post
also found significant (Z=2.34, p<0.05). This finding also
assessment scores of the experimental group on
indicates that there was significant difference between
WHOQOL-BREF. For this comparison, Wilcoxon Sign
Experimental and Control group in respect to this
Rank Test was used. After the analysis, it was found that
domain of Psychological Health. The mean value for
the mean score of Physical Health was found 10.80±1.39
Social Relationship was 14.20±1.22 of the Experimental
and 14.00±2.66 in the Baseline and post-test assessment
group and 12.20±1.39 of the control group. There was
sessions respectively. Significant difference was found
significant difference found between both the groups
between the baseline-assessment and post assessment
(Z=2.82, p<0.01) which suggests that there was
phase on this domain (Z=2.71, p<0.01) indicating that the
significant difference between the two groups in respect
performance of the Experimental group had
to this domain of social relationship. The mean value for
deteriorated further on this domain of Physical Health in
Environment was 15.80±2.25 and 13.40±1.42 of both the
the post assessment phase as compared to the pre-
groups respectively. The difference between these two
assessment phase. The mean score of Psychological
groups was also found significant (Z=2.39, p<0.05)
Health was found 10.40±1.34 and 14.30±1.63 in both the
suggesting significant difference between these two

Table 5

Baseline-post comparison on WHOQOL-BREF across both group

Variable Group (Mean ± SD) Mean Rank Z

Baseline Post Negative Positive

Ranks Ranks

Experimental Group

Physical Health 10.80±1.39 14.00±2.66 1.00 6.00 -2.712**

Psychological 10.40±1.34 14.30±1.63 .00 5.50 -2.831**
Health
Social 10.30±1.41 13.80±1.98 .00 5.50 -2.823**
Relationship

Environment 10.90±2.60 15.30±1.88 1.50 5.94 -2.669**

Control Group
Physical Health 9.60±1.42 12.50±1.50 .00 5.00 -2.677**
-
Psychological 10.70±1.88 12.40±1.34 2.50 5.31 2.395**
Health
Social 9.90±1.44 11.50±1.26 .00 5.00 -2.701**
Relationship

Environment 10.20±2.20 12.80±2.57 5.00 5.56 -2.307*

*p<0.05, **p<0.01, ***p<0.001

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Journal of Disability Management and Rehabilitation 4(1), 2018
 Improving Quality of life using Group therapy among Patients with Schizophrenia
sessions respectively. Significant difference was found
between pre and post assessment scores on this domain
(Z=2.83, p<0.01), indicating that there was significant
change in the Experimental group participants on this
domain in the post assessment phase as compared to the
pre-assessment phase. The mean Score of social
Relationship was found 10.30±1.41 and 13.80±1.98 in
both the sessions respectively. significant difference was
found between pre and post assessment scores on this
domain (Z=2.82, p<0.01), indicating that there was
significant change in the Experimental group
participants on this domain in the post assessment phase
as compared to the baseline-assessment phase. The
mean score of Environment was found 10.90±2.60 and
15.30±1.88 in both the sessions respectively. Significant
difference was found between baseline and post
assessment scores on this domain (Z=2.66, p<0.01). The
overall findings suggest that the experimental group
showed improvement in all the domains of WHOQOL-
BREF in the post assessment phase in comparison to the
baseline-assessment phase.
Second part of the table shows the comparison between
baseline-assessment and post assessment scores of the
control group. After the analysis, it was found that the
mean score of Physical Health in control group was
found 9.60± 1.42 and 12.50±1.50. Significant difference
was found between these two phases of assessment (Z=
2.67, P<0.01). This finding indicates that the control
group had improved significantly in the post assessment
phase as compared to the baseline assessment phase. The
mean score of Psychological Health was found
10.70±1.88 and 12.40±1.34 in both the sessions
respectively. significant difference was found between
pre and post assessment scores on this domain (Z=2.39,
P<0.01), indicating that there was significant change in
the control group participants on this domain in the post
assessment phase as compared to the baseline-
assessment phase. The mean Score of social Relationship
was found 9.90±1.44 and 11.50±1.26 in both the sessions
respectively. significant difference was found between
pre and post assessment scores on this domain (Z=2.70,
P<0.01), indicating that there was significant change in
the control group participants on this domain in the post
Journal of Disability Management and Rehabilitation 4(1), 2018
assessment phase as compared to the baseline-
assessment phase. The mean score of Environment was
found 10.20±2.20 and 12.80±2.57 in both the sessions
respectively. significant difference was found between
baseline and post assessment scores on this domain
(Z=2.30, p<0.05). The overall findings suggest that the
control group showed improvement in all the domains
of WHOQOL-BREF in the post assessment phase in
comparison to the baseline-assessment phase.
Table 6 shows the comparison between the post and
follow up assessment scores of the experimental group
on WHOQOL-BREF. For this comparison, Wilcoxon
Sign Rank Test was used. After the analysis, it was found
that the mean score of Physical Health was found
14.00±2.66 and 15.20±1.13 in the post and follow up-test
assessment sessions respectively. There was no
Significant difference found between the Post -
assessment and Follow-up assessment phase on this
domain (Z=1.25, P>0.05) indicating that the
experimental group had maintained improvement on
follow up on this domain. The mean score of
Psychological Health was found 14.30±1.63 and
15.40±1.83 in both the sessions respectively. No
significant difference was found between post and
followup assessment scores on this domain (Z=1.74,
p>0.05), indicating that experimental group had
maintained improvement on follow up in this domain.
The mean Score of social Relationship was found
13.80±1.98 and 14.20±1.22 in both the sessions
respectively. There was no significant difference was
found between post and follow up assessment scores on
this domain (Z=0.95, p>0.05), indicating that there was
no significant change in the Experimental group
participants on this domain The mean score of
Environment was found 15.3±1.88 and 15.80±2.25 in
both the sessions respectively. No significant difference
was found between post and follow up assessment
scores on this domain (Z=0.724, p>0.05). This finding
indicates that the performance of the experimental
group had improved further on this domain but the
difference was not significant. However, the
experimental group had maintained the therapeutic
gain on follow up. The overall findings indicate that the
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Vishmita et al

Table 6

Comparison between post and follow up on WHOQOL-BREF across both groups:.

Variable Group (Mean ± SD) Mean Rank Z

Post Follow up Negative Positive

Ranks Ranks

Experimental Group

Physical Health 14.00±2.66 15.20±1.13 4.00 5.50 -1.256(NS)

Psychological 14.30±1.63 15.40±1.83 5.50 4.36 -1.774(NS)
Health

Social 13.80±1.98 14.20±1.22 4.25 3.90 -0.954(NS)

Relationship

Environment 15.30±1.88 15.80±2.25 4.13 5.70 -0.724(NS)

Control Group

Physical Health 12.50±1.50 12.60±1.26 2.00 3.00 -0.378(NS)

Psychological 12.40±1.34 13.50±1.26 .00 3.00 -2.060*

Health

Social 11.50±1.26 12.20±1.39 2.50 3.70 -1.725(NS)

Relationship

Environment 12.80±2.57 13.40±1.42 4.75 6.00 -0.884(NS)

NS = Not Significant, *p<0.05, **p<0.01

difference obtained between all the variables was found up assessment phase as compared to the post-
to be not significant It shows that the therapeutic gain assessment phase. The mean Score of social Relationship
obtained after intervention was maintained on follow up was found 11.50±1.26 and 12.20±1.39 in both the
by the experimental group of WHOQOL-BREF. sessions respectively. significant difference was found
between post and follow up assessment scores on this
Second part of the table shows the comparison between
domain (Z=1.72, P>0.05), indicating that there was no
post-assessment and follow up assessment scores of the
significant change in the control group participants on
control group. After the analysis, it was found that the
this domain in the follow up assessment phase as
mean score of Physical Health in control group was
compared to the post-assessment phase. The mean score
found 12.50± 1.50 and 12.60±1.26. NO Significant
of Environment was found 12.80±2.57 and 13.40±1.42 in
difference was found between these two phases of
both the sessions respectively. No significant difference
assessment (Z= 0.37, P>0.05) indicating that the
was found between post and follow up assessment
physical health maintained the therapeutic gain on the
scores on this domain (Z=0.884, p>0.05). This finding
follow up in control group. The mean score of
indicates that the performance of the control group had
Psychological Health was found 12.40±1.34 and
not improved on this domain. However, control group
13.50±1.5 in both the sessions respectively. significant
had maintained the therapeutic gain on follow up. The
difference was found between post and follow up
overall findings indicate that the difference obtained
assessment scores on this domain (Z=2.06, P<0.05),
between all the variables was found to be not significant
indicating that there was significant change in the
except Psychological Health. It shows that the
control group participants on this domain in the follow
therapeutic gain obtained after intervention was

58
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Journal of Disability Management and Rehabilitation 4(1), 2018
 Improving Quality of life using Group therapy among Patients with Schizophrenia

maintained on follow up by the control group of not significantly different between two groups in the
WHOQOL-BREF. beginning of the study. in the end of the study showed
that occupational therapy had significant effect on some
DISCUSSION
psychosocial aspects of quality of life in case group
Aim of the present study was to see the role of group compared to the control group (P<0.001).
therapy for the management of quality of life in
Finding of our study is consistent with the study
Schizophrenia. In this study table-1 shows all patients
conducted by Gorena et al., (2005) in schizophrenic
were male, age range 25-35 years. Most of them belong to
patients; according to the study quality of life in both
different place of rural back grounds. Table 1 reveals that
functional and subjective dimension is poor during one
equally both group matched married and unmarried
month after a hospitalization and does not change
domains of marital status respectively. Majority of
significantly during 1-year follow-up.
patients belongs to Hindu religion and family income
5,000-10,000. In Quality of life related studied similar age Study indicate that follow up phase of experimental
groups were widely used, because of persons from group had maintained therapeutic gain in quality of life
similar age group are most expected to work so in this in table no. 4. Indicated that all domains of quality of life
way majority of the participants were from same age scale shows significant improvement (Malla, 2001;
group (Fitzgerald, 2001). Henkel,2000). These results suggest, that early
intervention may improve only short-term outcome
On baseline assessment both experimental and control
(Linszen, 2001). Bryson, Lysaker and Bell reported a
group were found to be comparable across all the
positive association between amount of participation in
domains of quality of life as shown in Table no 2. In terms
paid work activity and improvement in quality of life
of quality of life similar results were reported by Galuppi
(Bryson, et al., 2002). Foldemo and Bogren (2002), found
et al (2010) in which they reported similar level of quality
5-year follow-up of patients with schizophrenia who
of life in patients with schizophrenia. In their study they
were in-patients for more than 3 months. Patients
found mean score on quality of life perception as 3.21
fulfilled the criteria and were interviewed 6 months after
(0.94), on perceptions of health as 3.14 (0.98), on physical
their discharge. The interview with the patients
domain as 22.8 (5.2), on psychological domain as 17.8
included quality of life. At the follow-up, full insight into
(3.2), on social domain as 7.2 (2.9) and on environmental
their illness was shown by most of the patients. There are
domain as 24.4 (5.6). These findings are consistent with
several possible explanations associated with the
the findings of present study and supports the view that
increased quality of life, e.g. less unsatisfied items
patients with schizophrenia experiences significant low
among some patients and greater autonomy at the
quality of life.
follow-up. (Yildiz,2004).
However, in post assessment phase there is statistically
Table 5 shows comparison within both the groups on
significant difference was found in all the domain of
baseline and post-assessment scores suggests that at
quality of life between experimental and control groups.
post assessment phase, experimental group showed
Quality of life was found to be higher among
significant improvement in all domains of quality of life
experimental group in comparison to the control group
as compared to the control group.
as shown in table no.3. all domains the quality of life
scales, were found to be significantly changed after Table 6 shows that there were no significant changes in
group therapy. It appears that the group therapy has a all domains of quality of life in experimental group and
strongly positive effect on quality of life of patients with previous position was maintained in the group. The
schizophrenia compared to the use of only medication. reason seems to be that after post assessment, both the
Similar study was conducted by Foruzandeh et al. (2009) groups' maintained more or less same status as it was on
in Schizophrenic patients. Quality of life mean score was post assessment. experimental group though did not
59
Journal of Disability Management and Rehabilitation 4(1), 2018
Vishmita et al
improve further, but maintained the therapeutic gains
that were achieved due to the therapeutic intervention
program at the post assessment and follow up phase.
Similarly, control group also maintained the post
intervention phase status on follow up intervention
phase except Psychological Health. It shows that the
therapeutic gain obtained after intervention was
maintained on follow up by the control group.
The result of the present study reveals that group
therapy improves quality of life in patients with
schizophrenia. After completion of therapy, it was
found that the Experimental group improved
significantly as compared to control group in all the
areas i.e. Physical health, psychological health, social
relationship. environmental etc. Similiar study
conducted by Bechdolf (2010) studied the clinical
efficacy of cognitive behaviour therapy (CBT) for
patients with schizophrenia.
Present study was therefore to compare the effects of a
brief group CBT and a group psycho educational (PE)
programme in patients with schizophrenia on QoL. A
total of 88 in patients with schizophrenia receive a
therapy envelope of 8 weeks including either 16 sessions
of group CBT or eight sessions of group PE treatment.
QoL was assessed using the Modular System for Quality
of Life at baseline; post-treatment assessment and 6
month follow up. QoL improved significantly in both
treatments in most QoL dimensions. Within-group
effect sizes for general QoL at follow up were 0.25 for
CBT and 0.29 for PE. No significant differences between
CBT and PE were found at post-treatment and at 6
month follow up. (Laws et al., 2018).
Our study is consistent with the finding of the study by
Mohandoss (2017) found that the individual domains of
physical and psychological spheres differed
significantly between the schizophrenic patients and
normal controls in terms of quality of life.
Finding of the present study supports the study
conducted by Solanki et al. (2008) assess quality of life
(QOL) in patients with schizophrenia and to determine
influence of clinical factors and socio-demographic
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Journal of Disability Management and Rehabilitation 4(1), 2018
variables on QOL of schizophrenic patients. result
shows that Patients were having lowest QOL
scores in social relationships domain of WHO QOL -
BREF scale. Social relationship domain of QOL was
significantly negatively correlated with occupation with
employed patients reporting better QOL in this domain.
There was significant positive correlation of total
monthly income with social relationship domain and
total QOL.
A significant QOL improvement was reported in every
life domain of QOL measures used by Karow et al. (2005)
from baseline till 6th week rating however the final
rating which they conducted at for 2nd week showed no
changes in comparison to 6th week rating. This is
consistent with our findings that, Of patient significant
improvement in the QOL of the patients was noticed.
CONCLUSION
Schizophrenia is a severe and debilitating disorder,
which affects general health, functioning, autonomy,
subjective wellbeing, and life satisfaction of those
who suffer from it (Solanki et al., 2008). After Group
therapy improvement was found in communication,
free-time activities, social interaction and conversation.
The therapy process was found to help clients with
self-discloser, awareness about himself and his
problems, help to interact with others, improve quality
of life and their day to day activities within or outside the
group.
LIMITATIONS
The study has several limitations such as sample size
was small, only male patients were taken for
intervention, limited duration, because of short term of
intervention we didn't know the long-term effect of
quality of life in patients with schizophrenia.
FUTURE DIRECTION
A future study with bigger sample size can be
undertaken to study the impact of socio-demographic
and clinical variables on the improvement of quality of
life in patients with schizophrenia.
1
 Improving Quality of life using Group therapy among Patients with Schizophrenia
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Corresponding Author: Mr. Prem Prakash, Ph.D

Scholar, Department of Psychiatric Social Work, Ranchi
Institute of Neuro-Psychiatry and Allied Sciences,
Kanke, Ranchi, Jharkhand. Email: premcip09@gmail
.com

How to cite this article: Singh, V., Singh A.R.,

& Prakash, P. (2018). Improving Quality of Life using
Group Therapy among Patients with Schizophrenia.
J o u r n a lo f D i s a b i l i t y Man
agement and
Rehabilitation, 4(1), 51-62.

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Journal of Disability Management and Rehabilitation 4(1), 2018