Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T02:54:36.330Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictive factors of functional capacity and real-world functioning in patients with schizophrenia

Published online by Cambridge University Press:  15 April 2020

I. Menendez-Miranda ,
M.P. Garcia-Portilla ,
L. Garcia-Alvarez ,
M. Arrojo ,
P. Sanchez ,
F. Sarramea ,
J. Gomar ,
M.T. Bobes-Bascaran ,
P. Sierra  and
P.A. Saiz
...Show all authors
I. Menendez-Miranda
Affiliation:
Area de Psiquiatria, Universidad de Oviedo, c/Julian Claveria s/n, 33006Oviedo, Spain
M.P. Garcia-Portilla
Affiliation:
Area de Psiquiatria, Universidad de Oviedo, c/Julian Claveria s/n, 33006Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
L. Garcia-Alvarez*
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
M. Arrojo
Affiliation:
Servicio de Psiquiatría, Complejo Hospitalario Universitario de Santiago, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
P. Sanchez
Affiliation:
Unidad de Psicosis Refractarias, Hospital Psiquiátrico de Alava, Vitoria, Spain
F. Sarramea
Affiliation:
ESM Montoro, Hospital Reina Sofía de Córdoba, Spain
J. Gomar
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain Litwin Zucker Alzheimer's Disease Center, Feinstein Institute for Medical Research/AECOM, Manhassett, NY FIDMAG, Hermanas Hospitalarias Sant Boi de Llobregat, Spain
M.T. Bobes-Bascaran
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
P. Sierra
Affiliation:
Servicio de Psiquiatria, Hospital Universitario La Fe, Avda, Fernando Abril Martorell 106, 46026Valencia, Spain
P.A. Saiz
Affiliation:
Area de Psiquiatria, Universidad de Oviedo, c/Julian Claveria s/n, 33006Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
J. Bobes
Affiliation:
Area de Psiquiatria, Universidad de Oviedo, c/Julian Claveria s/n, 33006Oviedo, Spain Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
*
⁎Corresponding author at: CIBERSAM, Department of Psychiatry, University of Oviedo, Julian Claveria 6, 33006 Oviedo, Spain. Tel.: +34 985104219; fax: +34 985103553. E-mail address:[email protected] (L. Garcia-Alvarez).
Get access

Abstract

Purpose

This study was performed to identify the predictive factors of functional capacity assessed by the Spanish University of California Performance Skills Assessment (Sp-UPSA) and real-world functioning assessed by the Spanish Personal and Social Performance scale (PSP) in outpatients with schizophrenia.

Methods

Naturalistic, 6-month follow-up, multicentre, validation study. Here, we report data on 139 patients with schizophrenia at their baseline visit. Assessment: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), Sp-UPSA and PSP. Statistics: Pearson's correlation coefficient (r) was used to determine the relationships between variables, and multivariable stepwise linear regression analyses to identify predictive variables of Sp-UPSA and PSP total scores.

Results

Functional capacity: scores on the PSP and PANSS-GP entered first and second at P < 0.0001 and accounted for 21% of variance (R2 = 0.208, model df = 2, F = 15.724, P < 0.0001). Real-world functioning: scores on the CGI-S (B = −5.406), PANSS-N (B = −0.657) and Sp-UPSA (B = 0.230) entered first, second and third, and accounted for 51% of variance (model df = 3, F = 37.741, P < 0.0001).

Conclusion

In patients with schizophrenia, functional capacity and real-world functioning are two related but different constructs. Each one predicts the other along with other factors; general psychopathology for functional capacity, and severity of the illness and negative symptoms for real-world functioning. These findings have important clinical implications: (1) both types of functioning should be assessed in patients with schizophrenia and (2) strategies for improving them should be different.

Keywords

SchizophreniaFunctional capacityReal-world functioningPredictive factors
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 5 , July 2015 , pp. 622 - 627
Copyright
Copyright © Elsevier Masson SAS 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N.C.Scale for the assessment of negative symptoms. Iowa City: University of Iowa; 1983.Google Scholar
Bae, S.M., Lee, S.H., Park, Y.M., Hyun, M.H., Yoon, H.. Predictive factors of social functioning in patients with schizophrenia: exploration for the best combination of variables using data mining. Psychiatry Investig 2010;7(2):93–101.CrossRefGoogle ScholarPubMed
Best, M.W., Gupta, M., Bowie, C.R., Harvey, P.D.. A longitudinal examination of the moderating effects of symptoms on the relationship between functional competence and real world functional performance in schizophrenia. Schizophr Res Cogn 2014;1(2):90–95.CrossRefGoogle Scholar
Bowie, C.R., Reichenberg, A., Patterson, T.L., Heaton, R.K., Harvey, P.D.. Determinants of real-world functional performance in schizophrenia subjects: correlations with cognition, functional capacity, and symptoms. Am J Psychiatry 2006;163(3):418–425.CrossRefGoogle ScholarPubMed
Bowie, C.R., Leung, W.W., Reichenberg, A., McClure, M.M., Patterson, T.L., Heaton, R.K., et al.Predicting schizophrenia patients’ real-world behavior with specific neuropsychological and functional capacity measures. Biol Psychiatry 2008;63(5):505–511.CrossRefGoogle ScholarPubMed
Bowie, C.R., Depp, C., McGrath, J.A., Wolyniec, P., Mausbach, B.T., Thornquist, M.H., et al.Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. Am J Psychiatry 2010;167(9):1116–1124.CrossRefGoogle ScholarPubMed
Cardenas, V., Mausbach, B.T., Barrio, C., Bucardo, J., Jeste, D., Patterson, T.. The relationship between functional capacity and community responsibilities in middle-aged and older Latinos of Mexican origin with chronic psychosis. Schizophr Res 2008;98(1–3):209–216.CrossRefGoogle ScholarPubMed
García-Portilla, M.P., Bobes, J.. The new challenge in identifying the negative syndrome of schizophrenia. Rev Psiquiatr Salud Ment 2013;6(4):141–143.CrossRefGoogle ScholarPubMed
Garcia-Portilla, M.P., Gomar, J.J., Bobes-Bascaran, M.T., Menendez-Miranda, I., Sáiz, P.A., Muñiz, J., et al.Validation of a European Spanish-version of the University of California performance Skills Assessment (Sp-UPSA) in patients with schizophrenia and bipolar disorder. Schizophr Res 2013;150(2–3):421–426.CrossRefGoogle ScholarPubMed
García-Portilla, M.P., Sáiz, P.A., Bousoño, M., Bascarán, M.T., Guzmán-Quilo, C., Bobes, J.. Validation of the Spanish Personal and Social Performance scale (PSP) in outpatients with stable and unstable schizophrenia. Rev Psiquiatr Salud Ment 2011;4(1):9–18.Google ScholarPubMed
Gould, F., Bowie, C.R., Harvey, P.D.. The influence of demographic factors on functional capacity and everyday functional outcomes in schizophrenia. J Clin Exp Neuropsychol 2012;34(5):467–475.CrossRefGoogle Scholar
Gupta, M., Bassett, E., Iftene, F., Bowie, C.R.. Functional outcomes in schizophrenia: understanding the competence-performance discrepancy. J Psychiatr Res 2012;46(2):205–211.CrossRefGoogle ScholarPubMed
Guy, W.Early Clinical Drug Evaluation (ECDEU) assessment manual. Rockville: National Institute of Mental Health; 1976.Google Scholar
Harvey, P.D.. Assessment of everyday functioning in schizophrenia: implications for treatments aimed at negative symptoms. Schizophr Res 2013;150(2–3):353–355.CrossRefGoogle ScholarPubMed
Harvey, P.D.. Disability in schizophrenia: contributing factors and validated assessments. J Clin Psychiatry 2014;75(1):15–20.CrossRefGoogle ScholarPubMed
Harvey, P.D., Strassig, M.. Predicting the severity of everyday functional disability in people with schizophrenia: cognitive deficits, functional capacity, symptoms, and health status. World Psychiatry 2012;11:75–79.CrossRefGoogle ScholarPubMed
Harvey, P.D., Velligan, D.I., Bellack, A.S.. Performance-based measures of functional skills: usefulness in clinical treatment studies. Schizophr Bull 2007;33:1138–1148.CrossRefGoogle ScholarPubMed
Harvey, P.D., Heaton, R.K., Carpenter, W.T. Jr., Green, M.F., Gold, J.M., Schoenbaum, M.. Functional impairment in people with schizophrenia: focus on employability and eligibility for disability compensation. Schizophr Res 2012;140(1–3):1–8.CrossRefGoogle ScholarPubMed
Harvey, P.D., Raykov, T., Twamley, E.W., Vella, L., Heaton, R.K., Patterson, T.L.. Factor structure of neurocognition and functional capacity in schizophrenia: a multidimensional examination of temporal stability. J Int Neuropsychol Soc 2013;19(6):656–663.CrossRefGoogle ScholarPubMed
Heinrichs, R.W., Statucka, M., Goldberg, J., McDermid-Vaz, S.. The University of California Performance Skills Assessment (UPSA) in schizophrenia. Schizophr Res 2006;88(1–3):135–141.CrossRefGoogle Scholar
Ho, J.S., Moore, R.C., Davine, T., Cardenas, V., Bowie, C.R., Patterson, T.L., et al.Direct and mediated effects of cognitive function with multidimensional outcome measures in schizophrenia: the role of functional capacity. J Clin Exp Neuropsychiatry 2013;35(8):882–895.CrossRefGoogle ScholarPubMed
Holshausen, K., Bowie, C.R., Mausbach, B.T., Patterson, T.L., Harvey, P.D.. Neurocognition, functional capacity, and functional outcomes: the cost of inexperience. Schizophr Res 2013;152(2–3):430–434.CrossRefGoogle ScholarPubMed
Kay, S.R., Fiszbein, A., Opler, L.A.. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1997;13(2):261–276.CrossRefGoogle Scholar
Leifker, F.R., Bowie, C.R., Harvey, P.D.. Determinants of everyday outcomes in schizophrenia: the influences of cognitive impairment, functional capacity, and symptoms. Schizophr Res 2009;115(1):82–87.CrossRefGoogle ScholarPubMed
Leifker, F.R., Patterson, T.L., Bowie, C.R., Mausbach, B.T., Harvey, P.D.. Psychometric properties of performance-based measurements of functional capacity: test-retest reliability, practice effects, and potential sensitivity to change. Schizophr Res 2010;119(1–3):246–252.CrossRefGoogle ScholarPubMed
Leifker, F.R., Patterson, T.L., Heaton, R.K., Harvey, P.D.. Validating measures of real-world outcome: the results of the VALERO expert survey and RAND panel. Schizophr Bull 2011;37(2):334–343.CrossRefGoogle ScholarPubMed
Marder, S.R., Davis, J.M., Chouinard, G.. The effects of risperidone on the five dimensions of schizophrenia derived by factor analysis: combined results of the North American trials. J Clin Psychiatry 1997;58:538–546.CrossRefGoogle ScholarPubMed
Mausbach, B.T., Bowie, C.R., Harvey, P.D., Twamley, E.W., Goldman, S.R., Jeste, D.V., et al.Usefulness of the UCSD Performance-based Skills Assessment (UPSA) for predicting residential independence in patients with chronic schizophrenia. J Psychiatr Res 2008;42(4):320–327.CrossRefGoogle ScholarPubMed
McIntosh, B.J., Zhang, X.Y., Kosten, T., Tan, S.P., Xiu, M.H., Harvey, P.H.. Performance based assessment of functional skills in severe mental illness: results of a large study in China. J Psychiatr Res 2011;45(8):1089–1094.CrossRefGoogle ScholarPubMed
Morosini, P.L., Magliano, L., Brambilla, L., Ugolini, S., Pioli, R.. Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand 2010;101(4):323–329.Google Scholar
Patterson, T.L., Goldman, S., McKibbin, C.L., Hughs, T., Jeste, D.V.. UCSD Performance-based Skills Assessment: development of a new measure of everyday functioning for severely mentally ill adults. Schizophr Bull 2001;27(2):235–245.CrossRefGoogle ScholarPubMed
Peralta, V., Cuesta, M.J.. Psychometric properties of the Positive and Negative Syndrome Scale (PANSS) in schizophrenia. Psychiatry Res 1994;53(1):31–40.CrossRefGoogle Scholar
Rocca, P., Montemagni, C., Zappia, S., Piterà, R., Sigaudo, M., Bogetto, F.. Negative symptoms and everyday functioning in schizophrenia: a cross-sectional study in a real world-setting. Psychiatry Res 2014;218(3):284–289.CrossRefGoogle ScholarPubMed
Twamley, E.W., Doshi, R.R., Nayak, G.V., Palmer, B.W., Golshan, S., Heaton, R.K., et al.Generalized cognitive impairments, ability to perform everyday tasks, and level of independence in community living situations of older patients with psychosis. Am J Psychiatry 2002;159(12):2013–2020.CrossRefGoogle ScholarPubMed
Ventura, J., Hellemann, G.S., Thames, A.D., Koellner, V., Nuechterlein, K.H.. Symptoms as mediators of the relationship between neurocognition and functional outcome in schizophrenia: a meta-analysis. Schizophr Res 2009;113(2–3):189–199.CrossRefGoogle ScholarPubMed
Vesterager, L., Christensen, T.O., Olsen, B.B., Krarup, G., Melau, M., Forchhammer, H.B., et al.Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia. Schizophr Res 2012;141:251–256.CrossRefGoogle ScholarPubMed
WHO World report on disability. Geneva: World Health Organization; 2011.Google Scholar
Submit a response

Comments

No Comments have been published for this article.