Quality of life among people with substance use disorders: A serial mediation model considering self-stigma and psychological distress.

Abstract

People with substance use disorders (PWSUDs) frequently experience multifaceted challenges, including depression, stigma, and social instability, which can negatively affect their quality of life (QoL). The present study explored the potential predictors of QoL among PWSUDs. The sample consisted of 300 PWSUDs (85% males; mean [SD] age = 44.73 [10.01] years), comprising equal groups of PWSUDs with amphetamine, opioid, and alcohol concerns. Variables such as education, employment, depression, self-esteem, and stigma were assessed. The Taiwan version of the World Health Organization Quality of Life (WHOQOL) Questionnaire was adapted to assess QoL. Hierarchical regression analyses were conducted to examine associations with QoL across four domains. A multiple mediator modeling approach was used to assess whether self-stigma and depression mediated the relationship between perceived stigma and QoL. Higher depression scores were consistently associated with lower QoL across all domains. Education and employment were positively associated with physical QoL. In the psychological domain, both lower depression and higher self-stigma were associated with higher QoL. Perceived stigma was negatively associated with social QoL, and lower education predicted poorer environmental QoL. Mediation analyses suggested that depression played a stronger mediating role than self-stigma in the association between perceived stigma and QoL. Depression and stigma significantly related to QoL among PWSUDs. Mediational pathways suggest that targeting depression may mediate the negative association between stigma and QoL. Interventions addressing both affective and social dimensions may help promote recovery.