Positive mental health in schizophrenia and healthy comparison groups: relationships with overall health and biomarkers
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OBJECTIVE: Positive psychological factors (PPFs) have been reported to have a significant impact on health in the general population. However, little is known about the relationship of these factors with mental and physical health in schizophrenia. METHOD: One hundred and thirty-five outpatients with schizophrenia and 127 healthy comparison subjects (HCs), aged 26-65 years, were evaluated with scales of resilience, optimism, happiness, and perceived stress. Measures of mental and physical health were also obtained. Regression analyses examined associations of a PPF composite with health variables. RESULTS: Relative to the HCs, the schizophrenia group had lower levels of PPFs. However, there was considerable heterogeneity, with over one-third of schizophrenia participants having values within the 'normative' range. The PPF composite was positively related to mental and physical health variables and with biomarkers of inflammation and insulin resistance. The relationship between PPFs and mental health was particularly strong for individuals with schizophrenia. CONCLUSION: A sizable minority of adults with chronic schizophrenia have levels of resilience, optimism, happiness, and perceived stress similar to HCs. Psychosocial interventions to enhance PPFs should be tested in patients with serious mental illnesses, with the goal of improving their mental health (beyond controlling symptoms of psychosis) and their physical health.
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Associations of greater happiness include higher levels of resilience, optimism, and personal mastery, and healthier levels of biomarkers of stress.
“Associations of greater happiness include higher levels of resilience, optimism, and personal mastery, and healthier levels of biomarkers of stress 250 .”
From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [250]
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Şahin, F. (2020) · Journal of Psychiatric Nursing · doi:10.14744/phd.2020.09821 · Cited by 6 · see citing works
Happiness and Mental Disorders
Hernández, E. L. D., Brito, P. R. B., & Hernández, A. M. G. (2022) · Healthcare · doi:10.3390/healthcare10091781 · Cited by 5 · see citing works
“However, other studies report that people with mental disorders have levels of happiness comparable to those of people without mental disorders [10,13,20].”
BackgroundNguyen, T. T., & Jeste, D. V. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.07.037 · Cited by 4 · see citing works
“Although patients with schizophrenia tend to have lower mean levels of resilience, optimism, wisdom, happiness, and low perceived stress, there is considerable heterogeneity among patients, with one-third having levels comparable to those in healthy comparison subjects (Edmonds et al., 2018; Palmer et al., 2014).”
BackgroundResultSelf-citationLim, Y. (2022) · Psychiatry Investigation · doi:10.30773/pi.2022.0155 · Cited by 3 · see citing works
Jeste, D. V., & Gyan, E. (2026) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20260402 · Cited by 2 · see citing works
Self-citationKwarko-Fosu, A. T., & Lopez, K. J. (2022) · Leisure/Loisir · doi:10.1080/14927713.2022.2159863 · Cited by 1 · see citing works
Mehta, P., Dhar, R., & Messias, E. (2020) · Springer eBooks · doi:10.1007/978-3-030-33264-8_7 · Cited by 1 · see citing works
Positive Psychiatry for Schizophrenia and Other Psychotic Disorders
Eglit, G. M. L., Palmer, B. W., & Jeste, D. V. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108539593.010
Self-citation¿Necesitamos recetas para ser felices?
Hernández, E. L. D., Brito, P. R. B., & Hernández, A. M. G. (2021) · Cultura de los Cuidados · doi:10.14198/cuid.2021.61.02
“…resultados de estos estudios, destacan que la felicidad está asociada con la calidad de vida relacionada con la salud mental y a su vez con factores como menor estrés percibido, una mayor capacidad de recuperación y optimismo y un mayor dominio personal (Edmonds et al., 2018; Palmer et al., 2014).”
Positive Psychiatry and Mental Health
Schouler‐Ocak, M. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780192866929.013.4
Mehta, P., Starnes, C., Messias, E., & Grysman, N. (2025) · Springer eBooks · doi:10.1007/978-3-031-94645-5_7
- Authors
- Edmonds, E. C., Martin, A. S., Palmer, B. W., Eyler, L. T., Rana, B. K., & Jeste, D. V.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Edmonds, Emily C.
- ORCID
- Venue
- Aging & Mental Health
- Publisher
- Informa UK Limited
- Published
- 2016-11-11
- Volume
- 22
- Issue
- 3
- Pages
- 354-362
- ISSN
- 1360-7863 (ISSN-L)
- 1364-6915
- OpenAlex
- W2552244650
- Cited by
- 27
- References
- 79
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 3 · 2019: 7 · 2018: 4 · 2017: 1 · 2016: 1
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Locations
- Aging & Mental Health (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- NIH (R01 MH094151-01)
- NIMH T32 Geriatric Mental Health Program (MH019934)
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Keywords
- schizophrenia, positive mental health, positive psychological factors, resilience, optimism, happiness, perceived stress, mental health, physical health, biomarkers, inflammation, insulin resistance, psychosocial interventions, severe mental illness
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Female, Health Status, Health Surveys, Humans, Male, Mental Health, Middle Aged, Quality of Life, Schizophrenia, Schizophrenic Psychology, Self Concept, Severity of Illness Index, Biomarkers, Case-Control Studies, Resilience, Psychological
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