Disorganization and real-world functioning in schizophrenia: Results from the multicenter study of the Italian Network for Research on Psychoses

SCHIZOPHRENIA RESEARCH

卷:201

Article

Rocca, P.¹  Galderisi, S.²  Rossi, A.³  Bertolino, A.⁴  Rucci, P.⁵  Gibertoni, D.⁵  Montemagni, C.¹  Bellino, S.¹  Aguglia, E.⁶  Amore, M.⁷  Bellomo, A.⁸  Biondi, M.⁹  Carpiniello, B.¹⁰  Cuomo, A.^11,12  D'Ambrosio, E.⁴  dell'Osso, L.¹³  Girardi, P.¹⁴  Marchesi, C.¹⁵  Monteleone, P.¹⁶  Montemitro, C.¹⁷  Oldani, L.¹⁸  Pacitti, F.³  Roncone, R.¹⁹  Siracusano, A.²⁰  Tenconi, E.²¹  Vita, A.^22,23  Zeppegno, P.²⁴  Steardo, L., Jr.²  Vignapiano, A.²  Maj, M.² 

[1] Univ Turin, Dept Neurosci, Psychiat Sect, Via Cherasco 11, I-10126 Turin, Italy

[2] Campania Univ Luigi Vanvitelli, Dept Psychiat, Naples, Italy

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

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

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

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

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

[8] Univ Foggia, Psychiat Unit, Dept Med Sci, Foggia, Italy

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

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

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

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

[13] Univ Pisa, Sect Psychiat, Dept Clin & Expt Med, Pisa, Italy

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

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

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

[17] Univ G dAnnunzio, Chair Psychiat, Dept Neurosci & Imaging, Chieti, Italy

[18] Univ Milan, Dept Psychiat, Milan, Italy

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

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

[21] Univ Padua, Dept Neurosci, Psychiat Clin, Padua, Italy

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

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

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

关键词: Schizophrenia;    Conceptual disorganization;    Social cognition;    Functional capacity;    Real-world functioning;    Italian Network for Research on Psychoses (NIRP);   

DOI  :  10.1016/j.schres.2018.06.003

来源: Elsevier

【 摘 要 】

Background: A general consensus has not yet been reached regarding the role of disorganization symptoms in real-world functioning in schizophrenia. Methods: We used structural equations modeling (SEM) to analyze the direct and indirect associations between disorganization and real-world functioning assessed through the Specific Levels of Functioning Scale (SLOF) in 880 subjects with schizophrenia. Results: We found that: 1) conceptual disorganization was directly and strongly connected with SLOF daily activities; difficulty in abstract thinking was associated with moderate strength to all SLOF domains, and poor attention was connected with SLOF work skills; 2) grandiosity was only related with poor work skills, and delusions were associated with poor functioning in all SLOF domains; interpersonal relationships were weakly indirectly influenced by hallucinatory behavior, delusions and unusual thought contents through the mediation of social cognition (SC); 3) among the negative symptoms, avolition had only direct links with SLOF work skills and SLOF activities; anhedonia had direct links with SLOF work skills and SLOF interpersonal and indirect link with SLOF work skills through functional capacity (FC); asociality with SLOF interpersonal; blunted affect had direct links with SLOF activities and indirect links with SLOF interpersonal relationships mediated by SC. Lastly, alogia had only indirect links mediated by SC, FC, and neurocognition (NC). Conclusions: Overall conceptual disorganization is the symptom that contributed more (both directly and indirectly) to the activities of community living in real-world. Thus, it should be considered as a treatment target in intervention programs for patients with schizophrenia. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

Free