ORIGINAL PAPER Leonardo Arau ´jo de Souza Æ Evandro Silva Freire Coutinho The quality of life of people with schizophrenia living in community in Rio de Janeiro, Brazil Accepted: 20 January 2006 j Abstract Introduction The influence of sociode- mographics and clinical factors on the quality of life (qol) of an individual with schizophrenia is being widely studied, particularly in developed countries. The de-institutionalization process that is taking course in Brazil, to a less symptoms-focused ap- proach, makes necessary the assessment of the qol of these patients living in the community. Objectives To evaluate factors related to the qol in patients diag- nosed with schizophrenia or schizo-affective disorder, and who are users of one of the two municipal com- munity mental health services of a Rio de Janeiro district, Brazil. Material and methods A cross-sec- tional study was carried out. Selected patients were interviewed with Brazilian versions of Lancashire Quality of Life Profile, Brief Psychiatric Rating Scale and Calgary Depression Scale for Schizophrenia. Re- sults A total of 136 patients participated in the study. Most of them were single and lived with their rela- tives, had low educational level, were unemployed and had low income. A great number of the interviewed did not have any social contact outside the family and leisure activity, except watching television and/or listening to the radio. Finances and work situation had the lowest satisfaction level. Educational level, presence of positive and depressive symptoms, hos- pital admissions were negatively associated with qol. For those receiving state benefit, perceived qol in- creased with age. These predictors explained more than 42% of the total subjective qol score variance. j Key words quality of life – schizophrenia – com- munity care Introduction Quality of life (qol) has been a focus of concern in developed countries since the Second World War. The improvement in the standard of life in these countries led to more expectations, including happiness, satis- faction, well-being and personal achievement. Through the last three decades, qol has became a new paradigm representing the ideals of modern medicine [1]. The World Health Organization (WHO) defined qol as individuals’ perceptions of their position in life, in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns. Qol has been regarded as a broad-ranging concept that consists of four elements: physical health, social relationship, psychological state and relationship to salient features of the environment [2, 3]. Qol is a well-established area of study with regard to chronic diseases (rheumatology, oncology, and nephrology). However, only recently qol of people with severe mental disorders has received more attention from researchers, policy makers and health- care staffs. According to Oliver et al. [1] the psychiatric hospitals closure and the process of de-institutionali- zation, based on the resettlement and integration into the community of the severely mentally ill, are the two reasons for this great concern. Patients with severe and chronic mental disorders living in the community usually have a worse qol, when compared with healthy people [4]. Among these patients are the schizophrenics, a large group with specific characteristics and marked social dysfunction. This mental disorder represents a serious problem to public health, as it usually starts before the age of 30, when people are economically active [5–8]. L. A. de Souza (&) Rua Sa ˜o Clemente, 398/604 – Botafogo Rio de Janeiro, Brazil - CEP 22260-000 Tel.: +55-21/2286-8138 Tel.: +55-21/9162-5258 E-Mail: araujodesouza@uol.com.br araujodesouza@gmail.com E. Silva Freive Coutinho Depto. de Epidemiologia e Me ´todos Quantitativos em Sau ´de Escola Nacional de Sau ´de Pu ´blica/FIOCRUZ Rio de Janeiro, Brazil Soc Psychiatry Psychiatr Epidemiol (2006) xx:1–10 DOI 10.1007/s00127-006-0042-6 SPPE 42