Symptoms of psychosis and depression in middle-aged and older adults with psychotic disorders: the role of activity satisfaction

The presence of depressive symptoms among patients with psychosis is well documented in the literature. Behavioral models of depression emphasize the role of environmental factors in the onset and maintenance of depressive symptoms. The purpose of this study was to examine the efficacy of an activity-buffering model of well-being, in which increased satisfaction with leisure activities serves to moderate the relationship between symptoms of psychosis and multiple measures of well-being. Participants were 210 middle-aged and older adults with a diagnosis of schizophrenia or schizoaffective disorder. Analyses examined the main and interactive effects of positive symptoms, negative symptoms, and activity satisfaction for predicting both depressive symptoms and overall well-being. Results indicated that when individuals were less satisfied with their leisure activities, the relationship between negative symptoms and depressive symptoms was significant (p < 0.001). However, when individuals had high satisfaction, negative symptoms and depressive symptoms were no longer related (p = 0.243). Similar results were observed for overall well-being. These results provide initial support for an activity-buffering model of well-being among middle-aged and older patients with psychosis. Behavioral therapies which encourage engagement in reinforcing activities may provide additional benefits to existing treatments for psychosis, including reduced depression, improved well-being, and possibly functional outcomes.