The mediating role of rehabilitation status on the association between socioeconomic status and quality of life among individuals with severe mental illness

Abstract

Background: Individuals with severe mental illness (SMI) often experience lower socioeconomic status (SES) and rehabilitation status, leading to a poorer quality of life (QoL). This study aimed to explore whether rehabilitation status serves as a mediating factor in the relationship between SES and QoL in individuals with SMI. Methods: A total of 1,105 individuals with SMI from 23 community health centers in Nanjing were recruited through a random sampling method. The General Information Questionnaire, the Morning Side Rehabilitation Status Scale and the Medical Outcomes Study Short Form 36-item Survey were used for assessment. Latent class analysis was employed to categorize patients’ SES based on five socioeconomic indicators. Spearman’s rank correlation analysis was used to investigate the relationships between SES, rehabilitation status, and QoL. Path analysis was used to estimate the direct effect between SES on QoL and the indirect effect mediated by rehabilitation status. Results: The 1,105 patients were categorized into two groups based on their SES: low SES (796 patients, 72%) and high SES (309 patients, 28%). The findings revealed a negative correlation between SES and rehabilitation scores (r = -0.142, p < 0.001), whereas a positive correlation was observed between SES and QoL (r = 0.180, p < 0.001). Furthermore, a negative correlation was found between rehabilitation scores and QoL (r = -0.608, p < 0.001). The study also found that the relationship between SES and QoL was partially mediated by rehabilitation status, with a mediating effect value of 32%. Conclusions: Individuals with SMI experience impaired QoL, which may be improved by addressing both SES and rehabilitation status.