Psychiatry Investig.
2023 Nov;20(11):1034-1044. 10.30773/pi.2023.0169.
Sleep Quality and Self-Stigma Mediate the Association Between Problematic Use of Social Media and Quality of Life Among People With Schizophrenia in Taiwan: A Longitudinal Study
- Saffari M
1,2 - Chang KC3,4
- Chen JS5
- Potenza MN6-11
- Yen CF12,13,14
- Chang CW15
- Huang PC16
- Tsai HC17,18
- Lin CY16,19-22
- Affiliations
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- 1Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- 2Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
- 3Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- 4Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 5Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- 6Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- 7Connecticut Mental Health Center, New Haven, CT, USA
- 8Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- 9Child Study Center, Yale School of Medicine, New Haven, CT, USA
- 10Department of Neuroscience, Yale University, New Haven, CT, USA
- 11Wu Tsai Institute, Yale University, New Haven, CT, USA
- 12Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- 13Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- 14College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
- 15Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan
- 16Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 17Department of Psychiatry, School of Medicine, Tzu Chi University, Hualien, Taiwan
- 18Department of Psychiatry, Tzu Chi General Hospital, Hualien, Taiwan
- 19University of Religions and Denominations, Qom, Iran
- 20Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 21Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 22Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- KMID: 2547992
- DOI: http://doi.org/10.30773/pi.2023.0169
Abstract
Objective
Problematic use of social media (PUSM) may affect sleep quality and self-stigma in people with schizophrenia and consequently reduce their quality of life (QoL). This longitudinal study investigated if sleep quality and self-stigma mediated relationships between PUSM and QoL.
Methods
One-hundred-and-ninety-three outpatients with schizophrenia were recruited from a psychiatric center in Taiwan from April 2019 to August 2021 and participated in a longitudinal study at intervals of three months between measurements. QoL was assessed using the World Health Organization Quality of Life Questionnaire Brief Version; sleep quality using the Pittsburgh Sleep Quality Index; self-stigma using the Self-Stigma Scale-Short; and PUSM using the Bergen Social Media Addiction Scale. Via SPSS 20.0, general estimating equation models assessed temporal associations between variables. Via R software, mediating effects of self-stigma and sleep quality were examined through Monte Carlo simulations with 20,000 repetitions.
Results
Mean scores of physical, psychological, social and environmental QoL ranged from 11.86 to 13.02. Mean scores of sleep quality and self-stigma were 9.1±4.5 and 2.2±0.8, respectively. Sleep quality and self-stigma were directly related to QoL (p<0.001) and mediated indirect relationships between PUSM and all components of QoL with a range of 95% confidence intervals spanning from -0.0591 to -0.0107 for physical QoL; -0.0564 to -0.0095 for psychological QoL; -0.0292 to -0.0035 for social QoL; and -0.0357 to -0.0052 for environmental QoL.
Conclusion
Sleep quality and self-stigma mediated relationships between PUSM and QoL in people with schizophrenia. Developing interventions targeting PUSM, sleep, and self-stigma may help improve QoL in people with schizophrenia.
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