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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
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:lettti@gmail.com (L. Garcia-Alvarez).
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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.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2015

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