M127. Baseline Psychopathology as Predictors of Functional Outcome in Attenuated and Early First Episode Psychosis (original) (raw)
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Comprehensive psychiatry, 2013
Impairments in social functioning commonly seen in schizophrenia are thought to be mediated by deficits in the domains of social cognition. Some previous research has explored how social cognitive skills and psychotic symptoms are associated with social functioning, however these associations are still under debate. The main aim of this study was to investigate the relationship between different domains of social cognition and psychotic symptomatology, and also to look at the relationships with individual subdomains of social functioning within a clinically stable schizophrenia population. 45 outpatients were recruited and symptoms were assessed with the PANSS, and measures of emotion processing, affective and cognitive theory of mind (ToM), mental state reasoning attributional biases, and social functioning were taken. A correlational analysis was performed with the data. Following this, a regression analysis was used to reveal which domains of social cognition best predicted psychotic symptoms. In this stable group of patients, our results support the suggestion of a likely distinction between affective and cognitive components of ToM. The study also demonstrated that ToM and mental state reasoning were the best predictors of psychotic symptoms. Here we reveal that cognitive ToM had the most widespread relationship with social functioning, across multiple subdomains, while only some specific subdomains of social functioning correlated with other domains of social cognition and symptomatology. Further to this, positive symptoms were associated with much fewer subdomains of social functioning than negative and general symptoms. These findings imply that different aspects of social functioning may be served by different domains of social cognition and symptomatology.
Signs of social dysfunction are present early in the course of psychotic disorders. There is a lack of knowledge about how premorbid function, illness history, psychotic symptoms and neurocognitive characteristics are related to social function in patients with first episode psychosis (FEP). The relationship between these factors could provide important information about the psychopathology underlying social dysfunction and have implications for future prevention and treatment efforts. Our objective is to identify early predictors of social functioning in patients with FEP. We examined 166 patients and 166 age-and gender-matched healthy controls (HC). We used a validated and comprehensive measure of social functioning (the Social Functioning Scale), a comprehensive neurocognitive test battery, in addition to measures of psychotic symptoms, duration of untreated psychosis (DUP) and premorbid adjustment (the Premorbid Adjustment Scale). Lower childhood level of social adjustment and lower psychomotor speed had the strongest influence across measures of social functioning while symptoms and DUP had a weaker influence. The main result of the current study is that premorbid social adjustment and psychomotor speed had the strongest association with measures of social functioning in patients with FEP.
Social functioning in first-episode schizophrenia: 1-year follow-up study
Aim: was to compare social functioning of first-admitted schizophrenic patients with healthy controls and evaluate the influence of different variables on social abilities of patients, 1 month (T1), 13 months after hospitalization (T2) and 4-6 years after T1 (T3). Material and methods: A group of 74 schizophrenic patients: 46 male and 28 female; age 24.7 ± 6.7 and a control group of matched 52 male and 34 female subjects were enrolled. Social Functioning Scale (SFS), Positive and Negative Syndrome Scale (PANSS), Global Assessment Scale (GAS) and socio-demographic questionnaire were used. Results: In all examinations SFS scores in the patients (T1-103.5; T2-104.4; T3-107.0), were significantly lower than in the healthy controls-117.0 (p<0.001). In longitudinal analysis, a mild improvement was observed in T3 SFS score and in its three subscales (p<0.05) In cross-sectional analysis, better social functioning was associated with female sex, longer education, activity before admission, and better functioning in the pre-admission period. In regression analyses SFS at T2 was predicted by PANSS total scores at T1 (27% of the variance), and at T3 by PANSS total scores at T1 and duration of psychotic symptoms before the first hospitalization (20% of the variance). Conclusions: Social functioning in schizophrenia is impaired from the onset of disease and may be mildly improved in intermediate follow-up. Female sex, higher education and pre-admission functioning are correlated with better social outcome, however regression analysis point to the duration of untreated illness and severity of symptoms after the first admission, as important predictors of social functioning in early course of schizophrenia. social functioning / schizophrenia / first-episode / follow-up study
Insight in social behavioral dysfunction in schizophrenia: Preliminary study
Psychiatry and Clinical Neurosciences, 2008
Previous studies have demonstrated attenuated insight among schizophrenia subjects about having a mental disorder and about their psychopathology. Few studies, however, have investigated in detail patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; unconcern for their social behavioral problems. Using the subjective and objective versions of the Frontal Systems Behavior Scale (FrSBe), the nature of awareness of social behavioral problems was investigated in chronic schizophrenia subjects. First, schizophrenia subjects were found to have problems in three major domains of social behavior: apathy, disinhibition, and executive dysfunction. Second, awareness, estimated by the difference between the subjective and objective ratings, was not uniformly disturbed in schizophrenia subjects, although it had a significant interaction with the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; estimated IQs: subjects with higher IQs had a tendency to overestimate their problems, while those with lower IQs had the opposite tendency. Third, the same pattern of interaction was demonstrated for the retrospective premorbid ratings of FrSBe. Awareness among schizophrenia subjects of their social behavioral problems is affected by their cognitive capacity, and this applies not only to current behaviors but also to the retrospective estimation of their behaviors in the social domain.
Predictors of social cognition in patients with schizophrenia
Neuropsychiatric Disease and Treatment, 2006
The goal of this study is to explore neurocognitive, clinical and community functioning variables in order to predict "social reasoning" in a sample of patients with a diagnosis of schizophrenic disorder. Cognitive and community functioning, and social reasoning have been evaluated, together with the Positive and Negative Syndromes Scale (PANSS) and DSM-IV Global Assessment of Functioning (GAF), in a sample of 46 patients who met the DSM-IV criteria for schizophrenia. Our fi ndings show that global functioning as refl ected by GAF is the strongest predictor of the social reasoning as evaluated by the Wason's Selection Task (WST). Other community functioning variables such as the Life Skills Profi le (LSP) sub-scores do not provide signifi cant prediction of social reasoning. Similarly, neurocognitive measures, in terms of attention and contextual reasoning, have no predictive effect on social reasoning. Our fi ndings show that social cognition should be considered as an additional cognitive domain more related to functional outcome.
Objectives: Patients with schizophrenia are characterized with deficiencies in various aspects of social functioning. Given the relationship between social functioning deficits and relapse in these patients, identification of underlying factors is of significant importance. Thus, in this study, the contribution of each dimension of social cognition (Emotion Perception [EP], Theory of Mind [ToM] and Attributional Style [AS]) in predicting the social function of schizophrenic patients were examined. Methods: The statistical population included all patients with chronic schizophrenia hospitalized in Shiraz chronic healthcare centers. Of them, a total of 62 patients with schizophrenia disorder were selected based on purposive sampling method from three chronic care centers and were evaluated using social cognition tools (Hinting Task, Face Emotion Identification Task, and The Ambiguous Intentions and Hostility Questionnaire) and the Social Functioning Scale (SFS). Results: The results showed that ToM and EP predicted social functioning in people with schizophrenia but attributional style was not associated with social functioning. Discussion: On the whole, ToM and EP are general abilities contributing in explaining social functioning. However, the importance of attributional bias is significant when evaluating the performance of a person in specific areas such as aggressive behaviors.
Pretreatment social functioning predicts 1-year outcome in early onset psychosis
Acta Psychiatrica Scandinavica, 2006
social functioning predicts 1-year outcome in early onset psychosis. Objective: The aim was to investigate the association of pretreatment social functioning (12 months before initial presentation) with symptom dimensions and social functioning at 1-year follow-up. Method: Fifty-six adolescents, age 14-18, first admitted for early onset psychosis, were evaluated at baseline and 1-year follow-up assessing psychopathology (PANSS), social functioning (Strauss and Carpenter Prognostic Scale), and duration of untreated psychosis (DUP). Results: Adolescents with low pretreatment social functioning were at risk of more severe negative symptoms and lower social functioning at follow-up. Negative symptoms at baseline were less predictive and DUP was not predictive in this sample. Conclusion: Results of this study suggest a strong longitudinal interrelatedness between social functioning and negative symptoms in this age group. An integrative treatment approach including family interventions, social skills training, long-term specialized work/school rehabilitation, and adequate antipsychotic treatment is warranted to improve both, social functioning and negative symptoms.
Shanghai archives of psychiatry, 2012
Prior research has determined that impairment in neurocognition and psychiatric symptoms contribute to reduced occupational and social functioning in schizophrenia. Evaluate the relationships of neurocognition, psychiatric symptoms, and psychosocial functioning in male inpatients with schizophrenia in China. Fifty-one male patients currently hospitalised at the Shanghai Mental Health Center with a diagnosis of schizophrenia were recruited and 40 of them were included in the final analysis. Participants were assessed with Chinese versions of the Personal and Social Performance Scale (PSP), Clinical Global Impression-Severity (CGI-S) scale, Positive and Negative Symptom Scale (PANSS), Letter-Number Sequencing Task, and Hong Kong List Learning Test. Robust negative correlations were found between three clinical subscale scores derived from the PANSS and the global measures of social function (the total PSP score and the CGI-S score). Performance on the neurocognitive tasks was not asso...