Subjective well-being among clinically stable psychiatric outpatients: differences between mood disorders, subthreshold conditions, and community controls.

backgroundIn modern psychiatric care, subjective well-being (SWB) has become an important indicator of recovery beyond symptom remission. However, it remains uncertain how SWB differs among clinically stable psychiatric outpatients and whether symptom stability necessarily reflects subjective recovery.

methodsThis cross-sectional study compared SWB among clinically stable outpatients with mood disorders (M group; n = 59), a subthreshold group (ST group; n = 60), and community controls (CC; n = 204). The M group consisted of outpatients meeting DSM-5 criteria for depressive or bipolar disorders. The ST group comprised outpatients with persistent psychological distress—such as depressive mood, anxiety, and/or somatic complaints—who did not meet DSM-5 diagnostic criteria for any mood or anxiety disorders from initial assessment through enrollment. The CC group were recruited via an online survey panel. SWB was assessed using the Satisfaction with Life Scale (SWLS). Group differences were examined using covariance analysis, while predictors of SWB were explored using regression analysis.

resultsAfter adjustment, a significant group effect on SWLS scores was observed. The M group showed significantly higher SWB than both the ST group and CC, whereas the ST group exhibited the lowest SWB, even though all outpatient groups met predefined criteria for clinical stability. Subjective depressive symptoms were strongly associated with lower SWB, while engagement in purpose-related activities was associated with higher SWB after adjustment.

conclusionsSWB among clinically stable psychiatric outpatients is heterogeneous and cannot be sufficiently explained by symptom severity or diagnostic categories alone. The relatively high levels of SWB observed in the M group may reflect the inclusion of long-term clinically stable outpatients, age-related differences, and adaptive psychological processes following illness, such as effective coping strategies and the recalibration of internal standards. In contrast, the ST group appeared to represent a clinically important help-seeking population in which subjective distress and psychological vulnerability persisted despite the absence of full diagnostic criteria. These findings underscore the clinical relevance of assessing SWB in outpatient psychiatric care and underscore the need for interventions that strengthen psychosocial resources related to meaning and purpose. CLINICAL TRIAL NUMBER: Not applicable