The relationship between time perspective, functionality, and clinical variables in patients with schizophrenia

Objective: The aim of this study was to examine the relationship between time perspective, functionality, and clinical symptoms in patients with schizophrenia, and to evaluate these relationships more comprehensively by considering individuals chronotype characteristics. Method: The study was conducted at the Psychiatry Outpatient Clinic of Çukurova University Faculty of Medicine. The sample consisted of 100 patients diagnosed with schizophrenia who were followed up on an outpatient basis and 95 healthy controls matched in terms of sociodemographic characteristics. Participants were administered the Zimbardo Time Perspective Inventory (ZTPI), the Quality of Life Scale (QLS), the Calgary Depression Scale for Schizophrenia (CDSS), the Morningness-Eveningness Questionnaire (MEQ), the Positive and Negative Syndrome Scale (PANSS) and a sociodemographic data form prepared by the researchers. Results: Among patients with schizophrenia, the Past-Negative orientation (p = 0.018) was significantly higher, while Past-Positive (p = 0.009), Present-Hedonistic (p = 0.004), and Future (p <0.001) orientations were significantly lower compared to healthy controls; no significant difference was found for the Present-Fatalistic orientation (p = 0.19). Regarding the subscales of the Quality of Life Scale, the Interpersonal Relations subscale was negatively correlated with Past-Negative (rho = -0.233, p = 0.020) and positively correlated with Past-Positive (rho = 0.237, p = 0.018). The Occupational Role subscale showed a positive correlation with Past-Positive (rho = 0.223, p = 0.026) and Future (rho = 0.312, p = 0.002) orientations. Similarly, Objects and Activities correlated positively with Future orientation (rho = 0.240, p = 0.016), and total quality of life scores correlated positively with both Past-Positive (rho = 0.222, p = 0.026) and Future (rho = 0.284, p = 0.004) orientations. Significant correlations were also found between time perspective subscales, PANSS scores (positive, negative, general, and total), and depression scores. Conclusion: The time perspective profiles of patients with schizophrenia differed significantly from those of healthy controls. These individuals tended to evaluate their past more negatively, their future more uncertainly and hopelessly, and experienced reduced capacity for deriving pleasure from the present. Such distortions in time perspective were found to be associated with comorbid depression, symptom severity, and chronotype characteristics. These differences have important implications for the clinical course and quality of life in schizophrenia. Imbalances in time perspective may lead to diverse clinical presentations; therefore, treatment planning should consider not only symptom severity but also the individual's time perspective profile, functional level, and depressive symptoms within a holistic framework. Keywords: Schizophrenia, time perspective, functionality, chronotype.