Pathways to functional outcome in subjects with schizophrenia living in the community and their unaffected first-degree relatives

SCHIZOPHRENIA RESEARCH

卷:175

Article

Galderisi, Silvana¹  Rossi, Alessandro²  Rocca, Paola³  Bertolino, Alessandro⁴  Mucci, Armida¹  Bucci, Paola¹  Rucci, Paola⁵  Gibertoni, Dino⁵  Aguglia, Eugenio⁶  Amore, Mario⁷  Blasi, Giuseppe⁴  Comparelli, Anna⁸  Di Giannantonio, Massimo⁹  Goracci, Arianna^10,11  Marchesi, Carlo¹²  Monteleone, Palmiero¹³  Montemagni, Cristiana³  Pinna, Federica¹⁴  Roncone, Rita¹⁵  Siracusano, Alberto¹⁶  Stratta, Paolo²  Torti, Maria Chiara¹⁷  Vita, Antonio^18,19  Zeppegno, Patrizia²⁰  Chieffi, Marcello¹  Maj, Mario¹ 

[1] Univ Naples SUN, Dept Psychiat, I-80138 Naples, Italy

[2] Univ Aquila, Dept Biotechnol & Appl Clin Sci, Sect Psychiat, Laquila, Italy

[3] Univ Turin, Sect Psychiat, Dept Neurosci, Turin, Italy

[4] Univ Bari, Dept Neurol & Psychiat Sci, Bari, Italy

[5] Univ Bologna, Dept Biomed & Neuromotor Sci, Bologna, Italy

[6] Univ Catania, Dept Clin & Mol Biomed, Psychiat Unit, Catania, Italy

[7] Univ Genoa, Sect Psychiat, Dept Neurosci Rehabil Ophthalmol Genet & Maternal, Genoa, Italy

[8] Sapienza Univ Rome, Dept Neurosci Mental Hlth & Sensory Organs, S Andrea Hosp, Rome, Italy

[9] Univ G DAnnunzio, Dept Neurosci & Imaging, Chair Psychiat, Chieti, Italy

[10] Univ Siena, Dept Mol Med, Siena, Italy

[11] Univ Siena, Clin Dept Mental Hlth, Siena, Italy

[12] Univ Parma, Dept Neurosci, Psychiat Unit, Parma, Italy

[13] Univ Salerno, Dept Med & Surg, Chair Psychiat, Salerno, Italy

[14] Univ Cagliari, Sect Psychiat, Dept Publ Hlth Clin & Mol Med, Cagliari, Italy

[15] Univ Aquila, Dept Life Hlth & Environm Sci, Unit Psychiat, Laquila, Italy

[16] Univ Roma Tor Vergata, Dept Syst Med, Chair Psychiat, Rome, Italy

[17] Sapienza Univ Rome, Dept Neurol & Psychiat, Rome, Italy

[18] Univ Brescia, Sch Med, Psychiat Unit, Brescia, Italy

[19] Spedali Civili Hosp, Dept Mental Hlth, Brescia, Italy

[20] Univ Piemonte Orientale, Dept Translat Med, Psychiat Unit, Novara, Italy

关键词: Schizophrenia first-degree relatives;    Interpersonal relationships;    Work skills;    Avolition;    Cognition;    Structural equation model;   

DOI  :  10.1016/j.schres.2016.04.043

来源: Elsevier

【 摘 要 】

Rationale: Variables influencing real-life functioning have repeatedly been modeled in schizophrenia subjects but not systematically investigated in their unaffected first-degree relatives (SRs), in whom milder forms of deficits reported in schizophrenia have been observed, but confounders of clinical cohorts are not in play. Demonstrating that pathways to functional outcome are similar between patients and SRs would validate structural models developed in schizophrenia subjects. The present multicenter study aimed to explore whether variables associated with real-life functioning are similar in schizophrenia patients and their unaffected relatives. Methods: The study sample included 921 schizophrenia patients, 379 SRs and 780 healthy controls. Structural Equation Models (SEMs) were used in patients and SRs to test associations of psychopathological dimensions, neurocognition, social cognition, resilience, perceived stigma and functional capacity with real-life functioning domains, impaired in both patients and SRs. Results: Interpersonal Relationships and Work Skills were the only functional domains impaired in both patients and SRs. For both domains, functional impairment in patients was found to predict impairment in unaffected relatives, suggesting the involvement of similar illness-related vulnerability factors. In both groups variables significantly associated with Interpersonal Relationships included Social Cognition, Neurocognition, Avolition, Resilience, Disorganization, Perceived Stigma and Gender, and those significantly associated with Work Skills included Social Cognition, Neurocognition and Disorganization. Conclusions: Pathways to functional outcome for Interpersonal relationships and Work skills are similar between schizophrenia patients and their unaffected first- degree relatives. These findings validate, in the absence of con-founders of clinical cohorts, structural models of determinants of functional outcome in people with schizophrenia. (C) 2016 Elsevier B.V. All rights reserved.

【 授权许可】

Free