Exploring functioning in schizophrenia: Predictors of functional capacity and real-world behaviour. (May 2017)

• Record Type: Journal Article
• Authors: Bechi, Margherita; Bosia, Marta; Spangaro, Marco; Buonocore, Mariachiara; Cavedoni, Silvia; Agostoni, Giulia; Bianchi, Laura; Cocchi, Federica; Guglielmino, Carmelo; Smeraldi, Enrico; Cavallaro, Roberto
• Is Part Of: Psychiatry research. Volume 251(2017)
• Page Start: 118
• Page End: 124
• Publication Date: 2017-05
• Subjects: Social cognition -- Neurocognition -- Quality of life -- Daily functioning -- Psychosis -- Empathy -- Premorbid adjustment; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2017.02.019
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: Impairment in daily functioning still represents a major treatment issue in schizophrenia and a more in-depth knowledge of underlying constructs is crucial for interventions to translate into better outcomes. This study aims to model factors influencing both functional capacity and real-life behaviour in a sample of outpatients with chronic schizophrenia, through a comprehensive assessment including evaluations of psychopathology, cognitive and social cognitive abilities, premorbid adjustment, family environment and early childhood experiences. No significant correlation was observed between functional capacity and real-life behaviour. Functional capacity was significantly predicted by IQ, while real-life behaviour was significantly predicted by empathy, affect recognition and symptoms. Functional capacity seems mainly related to neurocognition, whereas real-life behaviour appears more complex, requiring the integration of different factors including symptoms, with a major role of empathy. Results thus support a divergence between the two constructs of functioning and their underlying components and highlight the need to target both dimensions through individualized sequential rehabilitation programs in order to optimize functional outcome. Highlights: Functioning is a treatment issue in schizophrenia. Functional capacity and real-world behaviour are two separate constructs. Functional capacity is mainly predicted by IQ. Real-world behaviour is mainly predicted by empathy. Rehabilitation programs need to sequentially target both constructs.