Year : 2013 | Volume : 40 | Issue : 1 | Page : 20-24
Comparison of demographic profile of patient with schizophrenia and depression
Sateesh R Koujalgi1, Shobhadevi R Patil2
1 Department of Psychiatry, Jawaharlal Nehru Medical College, Karnatak Lingayat Education Society University, Belgaum, India
2 Department of Social Work, Karnataka University, Dharwad, Karnataka, India
Date of Web Publication 28-Mar-2013
Sateesh R Koujalgi
Department of Psychiatry, Jawaharlal Nehru Medical College, Karnatak Lingayat Education Society University, Belgaum, Karnataka - 590 010
DOI: 10.4103/0974-5009.109686
Aim: To study and explore the socio-demographic profile of patients with schizophrenia and depression. Materials and Methods: Consecutively, 100 schizophrenia patients and 100 depression patients attending psychiatry department were included in the study. The International Classification of Diseases and Related Health Problems (ICD) - 10 criteria were used for diagnosis and these patients were assessed by self-developed socio demographic proforma. Statistical analysis was done using SPSS, version 17 software. Chi-square tests were done for comparison of the variables between the two groups. Results: Two groups of patients with schizophrenia and depression have differed on variables like age, gender, marital status, education, occupation, duration of illness, family history of psychiatric illness, and patient income. These groups did not differ on other socio-demographic variables like, urban/rural distribution, type of family, and religion. Conclusion: The study finds significant difference in demographic variables in schizophrenia and depressive disorder.
Keywords: Depression, schizophrenia, socio demographic variables
Koujalgi SR, Patil SR. Comparison of demographic profile of patient with schizophrenia and depression. J Sci Soc 2013;40:20-4
Koujalgi SR, Patil SR. Comparison of demographic profile of patient with schizophrenia and depression. J Sci Soc [serial online] 2013 [cited 2019 Jul 18];40:20-4. Available from: http://www.jscisociety.com/text.asp?2013/40/1/20/109686
Schizophrenia disorder is more prevalent in men than women. [1] The age of onset in females is about five years later (late 20 s) than males (early 20 s). [2] The nature and course of depressive illness severely affects the quality of life and productivity of the individual. [3] Depression is higher among women compared to men. [4]
From the available literature, it so far appears that socio-demographic variables of schizophrenia and depressive disorders have not yet been compared. Keeping this in mind, the present study was conducted with the aim of assessing and comparing both cohorts of socio-demographic variables.
The study sample consisted of two groups that were 100 patients with schizophrenia and 100 patients with depressive disorder. The data was collected from the psychiatry outpatient and inpatient department by adopting the stratified sample random sampling technique. Patients fulfilling the ICD - 10 DCR criteria for schizophrenia (all type) and depression (severe depression with or without psychotic symptoms) were included as samples of the study. Patients within the age group of 18 to 47 and above and having more than two years' history of illness were taken up for the study after ensuring confidentiality. Informed consent was obtained for such cases. Patients were excluded if they were found to have organic mental disorder or other co-morbid psychiatric disorder.
A structured socio-demographic variable proforma was prepared for the current study, which included the registration number, age, sex, marital status, religion, education status, occupation, duration of illness, family status, family history of mental illness, patient's income, and domicile. Data was analyzed using SPSS version 17 software. Descriptive statistics and Chi-square tests were used in analysis.
[Table 1] shows the details of socio-demographic variables of the study population. There were 12 (12%) schizophrenia patients between the age group 18 to 22 years and one (1%) in case of depression. 24 patients in both groups fell under the age category 23-27 years. Among them, 17 (17%) were observed having schizophrenia and seven (7%) had depression. The next age category was 28-32 years. Sixteen (16%) were found to have schizophrenia and 13 (13%) in case of depression. In 33-37yrs age category, 31 (31%) were observed having schizophrenia and 19 (19%) in case of depression. Sixteen (16%) of the schizophrenia patients and 22 (22%) of depressive patients were observed under the age category of 38 to 42 years, 7 (7%) of schizophrenia patients were found to be in the age category of 43-47, and 14 (14%) in the case of depression. One (1%) schizophrenia subject was found to be in the age category of 47 years and above and 14 (14%) in the case of depression. There was a significant difference between the two cohorts with regard to age ( P < 0.001).
Table 1: Comparison of the socio-demographic variable of schizophrenia disorder (n= 100) and depressive disorder (n= 100) group
In the gender category, the number of male respondents in the schizophrenia group were 57 (57%) and 43 (43%) were observed as female respondents. There were 37 (37%) male subjects in the schizophrenia group and 63 (63%) female subjects, which was statistically significant ( P < 0.001). It was observed that 57 (57%) schizophrenics remained unmarried, whereas, in the depression group only eight (8%) were found to be unmarried. Twenty nine (29%) of the respondents in the schizophrenia group were observed as married and 91 (91%) in the case of depression. When comparison was made in the divorce category, 14 (14%) of the schizophrenics were found to be divorced and one (1%) in case of depression, which was statistically significant ( P < 0.001).
When we observed religious affiliation in both groups, the majority of the subjects in both groups were Hindu 91 (91%) schizophrenia and 95 (95%) in the case of depression. There was no significant difference between the two groups with regard to religion ( P = 0.535).
In the schizophrenia group, five (5%) of the subjects were found to be illiterate and 2 (2%) in the case of depression, 23 (23%) studied in primary school in the schizophrenia group and ten (10%) in the case of depression, 55 (55%) schizophrenics had completed high school and 23 (23%) in the case depression, 16 (16%) had higher secondary education in the schizophrenia group and 23 (23%) in the case of depression, graduates were zero (0%) in the schizophrenia group, whereas in depression, 34 (34%) had completed a graduation course. Only one (1%) person was found to have post-graduation in the schizophrenia group and three (3%) in the case of depression. None of the subjects in the schizophrenia group had completed a professional course; whereas in depression five (5%) had completed a professional course, which was statistically significant ( P < 0.001).
In the occupation variable, five (5%) of schizophrenics were students and 2 (2%) in the case of depression. The number of unemployed people in the schizophrenia group was found to be 46 (46%), whereas two (2%) in the case of depression, employed people in the schizophrenia group were two (2%) whereas 22 (22%) were observed to be employed in the depression group. Professionals were zero (0%) in the schizophrenia group and two (2%) in the case of depression, zero (0%) people with schizophrenia were seen as government employees, whereas in depression three (3%) people were found to be government employees, zero (0%) belonged to private category in the schizophrenia group and two (2%) belonged to depression. 38 (38%) schizophrenics were found to be house wives and 57 (57%) in the case of depression, nine (9%) were found as agriculturists in the schizophrenia group and 10 (10%) in the case of depression. There was a significant difference between the two groups with regard to patient occupation ( P < 0.001).
Majority of the schizophrenics had a long-standing illness, which was 28 (28%) and 74 (74%) in the case of depression. There was a significant difference in both groups with regard to duration of illness ( P < 0.001).
Respondents of both groups were found to be living mostly living in nuclear families (70% vs. 74%), which was statistically non significant ( P = 0.107).
It was observed that both groups had a family history of mental illness (45% vs. 21%). There was a statistically significant difference between the two groups with regard to genetic load ( P < 0.001).
It was observed that ten (10%) of schizophrenia patients earned up to Rs 1,000 per month and one (1%) in the case of depression, zero (0%) of the schizophrenia group fall under the category of 1,001-5,000 and 18 (18%) in the case of depression, one (1%) schizophrenic could earn 5,001-10,000 and six (6%) in the case of depression, zero (0%) in the schizophrenia group were found to be under the category of 10,000 and more earning per month and 14 (14%) in the case of depression, 89 (89%) were seen non earning persons in the schizophrenia group and 61 (61%) in the case of depression. There was a statically significant difference in both groups with regard to income ( P < 0.001). Fifty nine (59%) of the schizophrenic study population were found to be residing in an urban area and 68 (68%) in the case of depression, two (2%) schizophrenics were observed to be residing in semi urban areas and zero (0%) in the case of depression, 39 (39%) schizophrenics were observed to be residing in a rural place, and 32 (32%) in the case of depression. There was no significant difference between the two groups with regard to domicile ( P = 0.241).
The current study was conducted including both outpatient and inpatient department of psychiatry. In this study, attempts were made to assess and compare the socio-demographic variable among schizophrenia and depressive disorder. In the west and India, the socio-demographic variable has been studied in both groups as part and parcel of the study, but there is no study, which has assessed and compared the socio demographic variable in schizophrenia and depressive disorder. It was observed that there was a significant difference between the two groups with regard to age of onset of illness ( P < 0.001). The available literature suggests that the schizophrenia illness occurs at a much younger age than depression, which is about 30 or late. The present study results were consistent with the previous studies. The study revealed that males dominated the schizophrenia group, whereas there was a predominant distribution of female was seen in the depression cohort, which was statistically significant ( P < 0.001). The study indicates that the prevalence of schizophrenia in men and women was equal when compared to depression, where females were more than males. The present study findings were similar to a previous study by Heru. [5] The life time prevalence of depression in women is 4.9% to 8.7% and in men 2.3% to 4.4%. One in four women and one in ten men have depression during their lifetime. [6] This could be because females are more vulnerable to stress, like daily hassles, role expectations, and major life events that require adaptive change in individuals. All these factors can contribute to the onset of depression. Stigma is a powerful weapon, which comes in the way of treatment, not only labeling a person as mentally ill, but also mental health services as a whole. The schizophrenia onset in females is about five years later (late 20 s) than males (early 20 s). This could be because females' hormones act as protective factors against abnormalities in neurotransmitter nervous system. [2] The study found a significant difference in both groups with regards to marital status ( P < 0.001). The study found that the ratio of unmarried people in the schizophrenia group was 57% and in the case of depression 8%. This difference could be due to the early onset schizophrenia illness as compared to depression in which age of onset is in 30 years or 40 years. Therefore, due to illness people with schizophrenia choose not get married as it can lead to adjustment problem for the partner and for themselves to too, adjustment in the martial life, whereas people with depression got married before the onset of illness. The divorce ratio in schizophrenia was high that of 14% and 1% in the case of depression. This is due to the fact that a married schizophrenic person could find difficulty in role expectation in terms of social, emotional, moral, and sexual. The study revealed no significant difference between the two groups with regards to religion. Majority of them were Hindus in both cohorts (91% vs. 95%) and rest were Muslims (5% vs. 2%). The study showed a significant difference in the acquisition of education between the schizophrenia and depression cohort. The acquisition of education in the schizophrenia group was much less when compared with the depression group. Cornblatt and Keilp [7] reported that person, who is genetically vulnerable to schizophrenia, would be having significant cognitive impairment; similarly person, who is assessed on cognitive parameter before they cultivate schizophrenia, is observed to have impairment in many of the cognitive domains. This could be one of the reasons why in our study many schizophrenics were studied up to high school that corresponds to age 14-17 yrs. Once the onset starts organizational ability, cognitive deficits significantly manifest impairment in persons with schizophrenia. Hence, it blocks education career of schizophrenics, whereas depression is a late age of onset and it does not manifest much disability, hence, in our study 34% of depressives were able to complete graduate course whereas 0% in case of schizophrenia. With regards to duration of illness, schizophrenia group had continued longer duration of illness while compared to depression that was statistically significant ( P < 0.001). This indicates depression is more of episodic in nature, whereas schizophrenia is continuous, chronic in nature. There was no significant difference between the two groups in the type of family, which was statistically non significant ( P = 0.107). However, both groups were dominated by nuclear family. This could be as a result of industrialization due to which there is an increasing trend towards changing to nuclear families. Earlier studies show that most of the mental illness occurs more in nuclear families, this is due to the joint family system breaking up and this transitional period of social life leads to higher disturbance in nuclear family. Moreover, dysfunctional family may precipitate mental illness and the presence of mentally ill in family can cause disturbed family. There was a significant difference between two groups when comparison made in history of mental illness in the family which was statistically significant ( P < 0.001). The study indicates that schizophrenia not only tends to run in families but that it is largely due to genes. The study findings are consistent with family studies done by Huber, Bogerts [8] and Woodruff PW [9] reported that schizophrenia illness could be observed in those biological parents where they were diagnosed as schizophrenia disorder. Whereas it was observed that the cause of depression could be explained in the parameters of environmental life stressors, cognitive, behavioral, and interpersonal conflict factors. There was a significant difference between two groups with regard to income ( P < 0.001). The study found schizophrenic population group were higher degree in low income category than depression. There could be many reasons, like problems in area of role functioning such as schooling or working typically starts with the onset of illness and which continues throughout the life time of ill person. Moreover, psychotic symptoms impair the vocational ability. Thus, person may find difficulty in work and consequently person may not earn adequate money, whereas, in depression symptoms are episodic which may not lead to vocational disability. Therefore, there are continued to earn. The study did not find much difference between the two groups with regard domicile concern ( P = 0.241). Fifty nine percent of schizophrenia subjects came from urban area and 67% in case of depression and 39% of schizophrenia group were seen in rural area and 32% in case of depression. The study did find the same results of study by Van [10] where they reported, urban living environment has been consistently found to be a risk factor for schizophrenia. MC Gurk [11] reported social disadvantages like poverty, racial discrimination, unemployment, family dysfunction and poor housing condition are high risk factor. Depression was also found more in urban area, which could be because of more stressors seen in urban area as compared to rural area. The current available literature also finds that depressive illness are more seen in urban than rural area. The literature on schizophrenia is almost double in urban area than rural and the present study findings are consistent with literature. As per effect on occupation of the client is concerned it was observed that schizophrenia group was significantly affected while compared to depression cohort which was statistically significant ( P < 0.001). Anthony [12] suggested that the person with schizophrenia would be having persistent disabilities in the areas of vocational and intellectual skills which are required to work in the community. The present study findings are consistent with the previous findings. Brekke [13] found the same results which reported that occupational functioning is almost universal feature of schizophrenia. This could be because person with schizophrenia are noticed to be having impairment in vocational ability, which includes getting, and retaining employment. The other possible impaired factor could be lack of adequate social competence and necessary social skill in work place. Many people with schizophrenia have deficits in communication skills like receiving, processing and sending information, and job survival skills like grooming, personal appearance, and politeness. Hence, due to all these factors person may not be able to get into employment. Depressive patient evaluate themselves negatively including their social and vocational abilities. Hence, this may not much interfere with their employment.
The present work highlighted difference in various non-illness variables in the patients of two groups of schizophrenia and depression. Age at onset of schizophrenia and depression significantly differ. Schizophrenic fared more poorly in education, occupational functioning, and many of them remained unmarried. Both groups, respectively, have revealed more of nuclear family, while religion, type of family, and domicile pattern did not differ in the two groups.
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[Table 1]
Koujalgi SR
Patil SR
socio demographic variables