BRIEF REPORT The Meaning in Life for Hospitalized Patients With Schizophrenia Stolovy Tali, MSW,* Lev-Wiesel Rachel, PhD,† Doron Adiel, MD,* and Gelkopf Marc, PhD*‡§ Abstract: This study investigated the relationship between the sense of meaning in life, quality of life, medical adherence, and duration of hospital- ization among 60 inpatients at the Lev Hasharon Medical Center in Israel. Participants included men and women diagnosed with schizophrenia, whose psychiatric histories dated back at least 5 years. Participants were adminis- tered the following self-report questionnaires: Purpose In Life (Crumbaugh and Maholick, 1968), Condensed Quality of Life Enjoyment and Satisfaction (Ritsner et al., 2005), Drug Attitude Inventory (Hogan et al., 1983), and Beck Depression Inventory-Fast Screen (Beck et al., 1997a). Results indicated that purpose in life correlated positively with quality of life and medical adher- ence, whereas negatively with depression. Furthermore, purpose in life correlated positively with the duration of the current hospitalization. The results are discussed in terms of a process of attachment to the hospital as the sense of life purpose emerges. Key Words: Meaning in life, purpose in life, quality of life, duration of hospitalization. (J Nerv Ment Dis 2009;197: 133–135) A ccording to existential psychology, the aspiration for meaning in life is a subjective feeling that is central to human existence, and is strongly correlated with quality of life. Indeed, empirical studies have shown that meaning in life is a major criterion for well being (Wheeler et al., 1990; Zubair, 1999) and satisfaction in life (Zika and Chamberlin, 1992). Alternatively, absence of meaning in life may be associated with pathology: neuroticism (Adad, 1987), psychoticism (Pearson and Sheffield, 1989), suicide ideation, and depression (Heisel and Flett, 2004; Mascaro and Rosen, 2005). Related studies involving the psychiatric inpatient population are scant. Researchers did find, however, low levels of meaning in life among people with schizophrenia (Chaudhary and Sharma, 1976; Gonsalvez and Gon, 1983; Yernell, 1971) or a first psychotic episode (Turner et al., 2007). Furthermore, the literature reports indicate that (a) life goals influence the motivation among individuals with persistent mental disorders to participate in and comply with treatment programs (Sivaraman, 2003), (b) compliance with medical treatment is likely to improve the patient condition; therefore, nonadherence should be considered a risk factor (Baloush-Kleinman et al., 2002; Fenton et al., 1997; Haywood et al., 1995), (c) internal subjective factors may strongly motivate adherence ( Baloush-Kleinman et al., 2002; Fen- ton et al., 1997), and (d) long-term or “chronic” psychiatric patients have difficulty finding meaning in their lives (Hidas and Farbstein, 1997; Sela, 1988). The longer the hospitalization, the less motivated the patients are in rehabilitation. This study sought to examine the relationship between meaning in life, quality of life, depression, medical adherence, and current hospitalization duration. It was hypothesized that meaning in life would correlate positively with quality of life and adherence, whereas correlating negatively with clinical depression and duration of current hospitalization. METHODS Participants The study included 60 inpatients, randomly chosen out of several wards at the Lev Hasharon Mental Health Center, Israel. Inclusion criteria were an ICD-10 diagnosis of schizophrenia, at least 1 hospitalization before the current hospitalization during the past 5 years, and basic verbal ability. Measures Meaning in Life The Purpose in Life questionnaire (Crambaugh and Maholick, 1968) was designed to measure the degree of meaning in life. It includes 20 items assessed on a 1 (not at all) to 7 (very much) Likert scale. The scale was found to be reliable with psychiatric and general populations (Adad, 1987). The questionnaire has a split-half reliability of 0.90 (Crambaugh and Maholick, 1968), and the present study found a satisfactory Cronbach’s  reliability of 0.85. Medical Adherence The Drug Attitude Inventory is designed to measure medical adherence (DAI-10, Hogan et al., 1983). It includes 10 items assessed as “true” or “false.” The inventory has been found to have a Kuder Richardson reliability of 0.93 and a test-retest reliability of 0.82 among psychiatric populations (Hogan et al., 1983). The present study found a satisfactory Cronbach’s  reliability of 0.73. Quality of Life This short version questionnaire Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ-18, Ritsner et al., 2005) is designed to measure quality of life enjoyment and satisfaction among inpatients diagnosed with schizophrenia, schizoaffective, and mood disorder. It consists of 18 items assessed on a scale of 1 (never) to 5 (always). The internal consistency ranges from 0.74 to 0.97, and test-retest reliability is 0.71 to 0.83 among outpatients and healthy subjects, respectively. The present study found a Cronbach’s  reliability of 0.86. Depression The 7-item Beck Depression Inventory-Fast Screen (BDI-FS, Beck et al., 1997a) is based on the 21-item Inventory (Beck et al., 1996). Each item contains 4 statements and the final score is the sum of ratings. The internal consistency was 0.86 among inpatients (Beck et al., 1997a) and 0.88 among outpatients (Beck et al., 1997b). The present study found a Cronbach’s  reliability of 0.70. Demographic Variables Current hospitalization duration, gender, age, country of birth, immigration date, and marital status were drawn from medical charts. *Lev Hasharon Mental Health Center, Tel-Aviv University, Netanya, Israel; †School of Social Work, University of Haifa, Israel; ‡Department of Com- munity Mental Health, University of Haifa Israel; and §NATAL: The Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel. Send reprint requests to Tali Stolovy, MSW, Lev Hasharon Mental Health Center, PO Box 90000, Netanya 42100, Israel. E-mail: istolovy@smile.net.il. Copyright © 2009 by Lippincott Williams & Wilkins ISSN: 0022-3018/09/19702-0133 DOI: 10.1097/NMD.0b013e3181963ede The Journal of Nervous and Mental Disease • Volume 197, Number 2, February 2009 133