Family Dynamics and Mental Health in Schizophrenia: Investigating the Impact of Cohesion and Adaptability

Purpose: This study aimed to examine how family cohesion and adaptability are associated with mental health outcomes, including functionality, mood, stress, and well-being, in individuals with schizophrenia. Methods: A total of 225 individuals diagnosed with schizophrenia spectrum and other psychotic disorders were included in the analysis. Participants were assessed using the Family Adaptability and Cohesion Evaluation Scale (FACES-III), Positive and Negative Syndrome Scale (PANSS-6), Drug Attitude Inventory (DAI-10), Social and Occupational Functioning Assessment Scale (SOFAS), Health of the Nation Outcome Scales (HoNOS), Beck Depression Inventory (BDI-I), Perceived Stress Scale (PSS-10), Subjective Well-being under Neuroleptics Scale (SWN-20), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Multidimensional Scale of Perceived Social Support (MSPSS). K-means clustering was performed to classify participants into distinct groups based on FACES-III scores. Results: K-means clustering, based on FACES-III scores, classified participants into high cohesion and adaptability (HC-HA; N = 139) and low cohesion and adaptability (LC-LA; N = 86) groups. No significant differences were observed in symptom severity (PANSS-6), medication adherence (DAI-10), or functionality measured by SOFAS. However, overall psychosocial functioning (HoNOS) was better in the HC-HA group. The HC-HA group exhibited lower depressive symptoms (BDI-I) and stress levels (PSS-10), as well as higher subjective well-being (SWN-20) and mental well-being (WEMWBS) compared to the LC-LA group. Perceived social support (MSPSS) was significantly higher in the HC-HA group. Conclusion: Family cohesion and adaptability are associated with improved psychosocial outcomes in individuals with schizophrenia. These findings suggest that enhancing family dynamics may support recovery and well-being.