Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder

SCHIZOPHRENIA RESEARCH

卷:169

Article

Moore, Raeanne C.^1,2  Harmell, Alexandrea L.^1,3  Harvey, Philip D.⁴  Bowie, Christopher R.⁵  Depp, Colin A.^1,2,7  Pulver, Ann E.⁶  McGrath, John A.⁶  Patterson, Thomas L.¹  Cardenas, Veronica^1,2  Wolyniec, Paula⁶  Thornquist, Mary H.⁶  Luke, James R.⁶  Palmer, Barton W.^1,2  Jeste, Dilip V.^1,2  Mausbach, Brent T.^1,2 

[1] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA

[2] Univ Calif San Diego, Sam & Rose Stein Inst Res Aging, San Diego, CA 92103 USA

[3] Univ Calif San Diego, San Diego State Univ, Joint Doctoral Program Clin Psychol, San Diego, CA 92103 USA

[4] Univ Miami, Miller Sch Med, Coral Gables, FL 33124 USA

[5] Queens Univ, Dept Psychol, Kingston, ON K7L 3N6, Canada

[6] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21218 USA

[7] VA San Diego Healthcare Syst, San Diego, CA USA

关键词: Serious mental illness;    Functioning;    Disability;    Neuropsychological assessment;    Cognitive remediation;    Functional capacity;   

DOI  :  10.1016/j.schres.2015.09.017

来源: Elsevier

【 摘 要 】

Objective: Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. Method: Two independent samples were studied. Study 1: participants with schizophrenia (n=435) and bipolar disorder (n=390) aged 18-83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range=39-72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. Results: Significant linear and quadratic trends were observed for both studies. Study 1: in both the schizophrenia and bipolar participants, when cognitive composite z-scoreswere >0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: when neuropsychological screening battery z-scores were >-1 (indicating low average to average performance), cognition was not related to functional capacity. Conclusions: These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition. Published by Elsevier B.V.

【 授权许可】

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