Mental Health During the Whole Life Cycle of Community Patients With Schizophrenia

The Brief Psychiatric Rating Scale (BPRS) was used to measure the presence and severity of psychiatric symptoms entailing positive symptoms, general psychopathology, and affective symptoms (e.g., thought disturbance, emotional withdrawal, hostility, and suspiciousness) for patients with mental illness, particularly schizophrenia. Each of the 18 items are designed to represent a discrete symptom area. Items are rated on a 7-point Likert scale, from 1 = "not present" to 7 = "extremely severe", with scores ranging from 18 to 126 (achieved through summing the item scores). Higher scores indicated more severity of psychiatric symptoms.

Reduction rate was calculated using the following formula: reduction rate= (Score before treatment - Score after treatment)/(Score before treatment - 18) × 100%. A reduction rate of BPRS score > 25% was considered as a clinically meaningful improvement.

The BPRS reduction rate during the 2-year follow-up period.

The BPRS reduction rate during the 3-year follow-up period.

The BPRS reduction rate during the 4-year follow-up period.

The BPRS reduction rate during the 5-year follow-up period.

The Modified Overt Aggression Scale (MOAS) is a four-part behavior rating scale used to evaluate and document the "frequency and severity" of aggressive episodes. The rating scale is made up of four categories; verbal aggression, aggression against objects, aggression against self, and aggression against others. Each category consists of five responses, which over time can track the patient's aggressive behavior. The MOAS is one of the most widely used measures for violence and aggression, with 4 items in total, 0~4 points for each item.

The WHO Quality of Life Scale-Brief (WHOQOL-BREF) was developed by the Word Health Organisation as a quality of life assessment that would be applicable cross-culturally. It is a 26 item self report measure, especially useful for measuring outcomes with adults with a psychosocial disability. The WHOQOL-BREF measures four factors: physical health, psychological Health, social relationships, and environment. The total score is presented between 26 and 156, where higher scores represent higher levels of quality of life.

The Generalized Anxiety Disorder Screener (GAD-7) is a brief, 7-item self-report measure for anxiety symptoms in adolescents and adults. Although developed primarily as a screening tool for GAD, it can also be used as a diagnostic tool to monitor changes in symptoms over time, and as a screener for social anxiety, panic disorder, and post-traumatic stress disorder. Each item is rated on a likert-type scale from zero ("not at all") to three ("nearly every day"), with total scores ranging from 0 to 21.

The Patient Health Questionnaire-9 (PHQ-9) is a multipurpose instrument for screening , diagnosing , monitoring and measuring the severity of depression. The tool rates the frequency of the symptoms which factors into the scoring severity index. The PHQ -9 is brief and useful in clinical practice. The PHQ -9 can be administered repeatedly , which can reflect improvement or worsening of depression in response to treatment .Each item is rated on a likert-type scale from zero ("not at all") to three ("nearly every day").

The Pittsburgh Sleep Quality Index (PSQI) is an effective instrument used to measure the quality and patterns of sleep in adults. It differentiates "poor" from "good" sleep quality by measuring seven areas (components): subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction over the last month. The questionnaire consists of a combination of Likert- type and open-ended questions. Respondents are asked to indicate how frequently they have experienced certain sleep difficulties over the past month and to rate their overall sleep quality. Scores for each question range from 0 to 3, with higher scores indicating more acute sleep disturbances.

The 10-item social disability screening schedule (SDSS) was used for measuring social function. It is a shortened version of psychiatric disability assessment schedule (DAS). SDSS was used to evaluate social disability, with 10 items in total, 0~2 points for each item.

Relapse of patients with schizophrenia is defined as a clinical deterioration or an exacerbation of symptoms based on rehospitalization. Data from the Shanghai Mental Health Work Website.

The rehospitalization rate from Baseline during the 2-year follow-up period.

The rehospitalization rate from Baseline during the 3-year follow-up period.

The rehospitalization rate from Baseline during the 4-year follow-up period.

The rehospitalization rate from Baseline during the 5-year follow-up period.

The primary health provider will follow up the patients every 3 months. If they learn about the violent behavior of the patient with schizophrenia during the follow-up process, they will record them on the Shanghai Mental Health Work Website.

2-year the number of violent incidents

3-year the number of violent incidents

4-year the number of violent incidents

5-year the number of violent incidents

The primary health provider will follow up the patients every 3 months. If they learn about the suicide in individuals with schizophrenia during the follow-up process, they will record them on the Shanghai Mental Health Work Website.

2-year the number of suicides

3-year the number of suicides

4-year the number of suicides

5-year the number of suicides