The purposes of this study were 1) to explore the associations between individual factors, disease factors, family factors, social factors and quality of life ( QoL ), 2) to predict QoL in patients with chronic mental illness ( CMI ), and 3) to understand the needs of caregivers. A cross-sectional and cluster sampling was employed. Structured questionnaires, including a living conditions questionnaire and a psychotic symptom assessment scale, Caregiver Burden Scale, 5-item Brief Symptom Rating Scale ( BSRS-5 ), and the Medical Outcomes Study Short Form-12 ( MOS SF-12 ) were used to collect data. Totally, 2023 patients were recruited, males 52.9%, females 47.1%, and a mean age of 44.99¡Ó12.09. Most of these cases were high school educated, unemployed, and had been hospitalized. 12.6% had a history of violence, 8.4% had a history of attempted suicide, 10% had substance abuse, and 5.4% had legal related issues. The most common diagnoses were schizophrenia¡]70.5%¡^and affective disorder¡]19.7%¡^. Single-factor analysis showed those who were unmarried, employed, younger, having less psychological problems, and low levels of psychological distress had better QOL. Besides, sex and education were not related to QOL in personal factors. Current psychotic symptoms and positive symptoms were negatively correlated with QOL. Schizophrenic patients and hospitalized patients reported higher QOL than bipolar patients and community patients in disease factors. Caregiver¡¦s attitude and caregiver¡¦s burden were negatively correlated with QOL in family factors. The unstable housing and community life dysfunction were negatively correlated with QOL in social factors. All significantly correlated variables were entered into hierarchical regression analysis followed the sequence of social factors, family factors, disease factors and individual factors. The results showed all four of these dimensions were significant predictors of MCS and PCS of QoL, explained variance 48.2¢H and 21.2¢H, respectively. Conclusions: Individual factors and disease factors are the most important factors in predicting QoL in CMI patients. Second, family factors are more important than social factors in MCS, and social factors are more important than family factors in PCS. The above evidence indicates a wide range of factors must be considered to improve the QoL in CMI patients.

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This project emerges from engaging and studying the lives, including mine, of the many who go—and stay—crazy. Here, I explore the kinds of existences that those impaired by severe and persistent mental illness(es), what I refer to henceforth as “chronic mental illness”— have had (or been able) to forge and leverage, as well as some of the resources and structures they have developed/manipulated in order to do so. This thesis explores one way in which chronically mentally ill people exact agency over their own embattled personhood. The term “personhood” draws from existential traditions in philosophy and theology (Strawson 1959; Taylor 1989, 127-142; Rosfort 2018), though I understand and use it here as it is relevant to phenomenological psychopathology. By “personhood”, I mean the normative traits of a society wherein individuals are recognized by seemingly “common” traits of humanity. While there is not, as philosopher Robert Spaemann contends, “a [single] characteristic that can be called ‘being a person’” (Spaemann 1996, 14), to understand human beings (being) is to also grapple with the ethical demands of intentionality, autonomy, experience, and subjectivity. By “subjectivity”, I refer to the innumerable and descriptive components that comprise individual, relational, and intersubjective experience(s). These components, and how they are known and described, emerges from a self-awareness in maneuvering the world and, consequently, developing a particular lifeworld. My interests in personhood and subjectivity emerge from the assumption that “the fragility of human identity is rooted in the various ways in which our biology challenges our experience of being an autonomous self” (Ricoeur 1966; Ricoeur 1970, 472; Rosfort 2018, 5). Part of what complicates personal identity is the impossibility of grounding personhood in either biological otherness or an intrinsic, pre-reflective selfhood. Being a person is “the task of becoming […] concrete […] through the constant encounter with the otherness that is an inescapable part of one’s identity” (Rosfort 2018, 6). Seeing a person, Ricoeur believes, requires the perpetual examination of experiential tensions among identity traits that go beyond biological reductionism and constancy. Illness narratives are useful tools for understanding the extent to which disability incites a fundamental interrogation of the self, as well as a reckoning of practices of self-recognition and phenomenological metamorphosis. This multi-field site investigation engages self-identifying psychiatrically disabled people via participant-observation at three peer support networks within the greater Boston area. Data, by way of stories recounted and collected, is framed by my own lived experience participating in similar structures, both in-person and online. Stories from both occasions, including interview data and media analysis, are relayed as means of triangulation. This project relies on sociologist Noman Denzin’s concept of “cumulative epiphanies” (Denzin 1989), or, moments wherein ill authors/speakers recognize the extent to which their personhood was honed through the medium of the illness itself (Frank 1993, 46). In large part, this project explores ways that people experiencing disabling effects of mental illness learn to take care of themselves. It pays particular attention to how the personal views of people with such illnesses shape the construction and layout of varied peer support networks. Although it considers general psychiatric practice involving prescribing clinicians (e.g., physician or nurse practitioner) and non-prescribing clinicians (e.g., talk therapists), the central objective is to consider the emergence of mutual support, or “self-help” models, as a mode of constructing a new sense of self/advocating for unmet needs within traditional medical practice. More broadly, this project maps the reflexive transformation(s) of person into patient and the varied methods of healing and treatment that the chronically mentally ill utilize in such contexts. It considers the emergence of PSNs as a counter/cultural borderland (Kleinman 1980; Garcia 2016) between the social “psy”ences (Matza 2013; Raikhel & Bemme 2016) and psychiatry. As a theoretical fusion of history of psychiatry, sociology of mental health, and phenomenology, I trouble the parameters within which PSNs and their participants help craft, shape, and directing a particular kind of experience of mental illness, suffering, and/or convalescence.

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No description available.