scholarly journals Predicting Real-World Functioning in Schizophrenia: The Relative Contributions of Neurocognition, Functional Capacity, and Negative Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
Zixu Yang ◽  
Soon Hong Lee ◽  
Nur Amirah Abdul Rashid ◽  
Yuen Mei See ◽  
Justin Dauwels ◽  
...  
Keyword(s):  
Functional Capacity ◽  
Real World ◽  
Employment Status ◽  
Negative Symptoms ◽  
Symptom Assessment ◽  
Brief Assessment ◽  
Multnomah Community Ability Scale ◽  
Logistic Regressions ◽  
Objective Outcome ◽  
Additional Variance

Neurocognition and functional capacity are commonly reported predictors of real-world functioning in schizophrenia. However, the additional impact of negative symptoms, specifically its subdomains, i.e., diminished expression (DE) and avolition-apathy (AA), on real-world functioning remains unclear. The current study assessed 58 individuals with schizophrenia. Neurocognition was assessed with the Brief Assessment of Cognition in Schizophrenia, functional capacity with the UCSD Performance-based Skills Assessment (UPSA-B), and negative symptoms with the Negative Symptom Assessment-16. Real-world functioning was assessed with the Multnomah Community Ability Scale (MCAS) with employment status as an additional objective outcome. Hierarchical regressions and sequential logistic regressions were used to examine the associations between the variables of interest. The results show that global negative symptoms contribute substantial additional variance in predicting MCAS and employment status above and beyond the variance accounted for by neurocognition and functional capacity. In addition, both AA and DE predict the MCAS after controlling for cognition and functional capacity. Only AA accounts for additional variance in employment status beyond that by UPSA-B. In summary, negative symptoms contribute substantial additional variance in predicting both real-world functioning and employment outcomes after accounting for neurocognition and functional capacity. Our findings emphasize both DE and AA as important treatment targets in functional recovery for people with schizophrenia.

Predictive factors of functional capacity and real-world functioning in patients with schizophrenia

2015 ◽  
Vol 30 (5) ◽  
pp. 622-627 ◽  
Author(s):  
I. Menendez-Miranda ◽  
M.P. Garcia-Portilla ◽  
L. Garcia-Alvarez ◽  
M. Arrojo ◽  
P. Sanchez ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Functional Capacity ◽  
Real World ◽  
Negative Symptoms ◽  
Social Performance ◽  
Performance Skills ◽  
Predictive Variables ◽  
Syndrome Scale ◽  
Report Data ◽  
Negative Syndrome

AbstractPurposeThis 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.MethodsNaturalistic, 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.ResultsFunctional 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).ConclusionIn 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.

scholarly journals The Impact of Negative Symptoms and Neurocognition on Functioning in MDD and Schizophrenia

2021 ◽  
Vol 12 ◽  
Author(s):  
Yue Feng Quek ◽  
Zixu Yang ◽  
Justin Dauwels ◽  
Jimmy Lee
Keyword(s):  
Depressive Symptoms ◽  
Negative Symptoms ◽  
Symptom Assessment ◽  
The Other ◽  
Healthy Controls ◽  
Neurocognitive Deficits ◽  
Occupational Functioning ◽  
Brief Assessment ◽  
Patient Health ◽  
The Impact

Introduction: Negative symptoms, neurocognitive deficits and functional impairment are prevalent in individuals with major depressive disorder (MDD) and schizophrenia (SCZ). However, unlike neurocognitive deficits, little is known about the role of negative symptoms toward functioning in individuals with MDD. On the other hand, both factors are well-studied in individuals with SCZ. Thus, this study aimed to examine the contributions of negative symptoms and neurocognitive impairments in functioning in individuals with MDD, compared to individuals with SCZ.Methods: Participants included 50 individuals with MDD, 49 individuals with SCZ and 49 healthy controls. The following measures were administered—Negative Symptom Assessment (NSA-16), Brief Assessment of Cognition in Schizophrenia (BACS), Patient Health Questionnaire (PHQ-9), and MIRECC-Global Assessment of Functioning (MIRECC-GAF) to evaluate negative symptoms, neurocognition, depressive symptoms, and functioning respectively.Results: Both MDD and SCZ groups had significantly more severe negative symptoms, depressive symptoms, and poorer functioning than healthy controls. Individuals with SCZ performed significantly poorer on the BACS than the other two groups. Both negative symptoms and neurocognition were significantly correlated with social and occupational functioning in SCZ. Motivation subdomain of the negative symptoms was significantly correlated with occupational functioning, while depressive symptoms correlated with functioning in MDD.Conclusion: Both negative symptoms and neurocognitive deficits appear to play differential roles on individual domains of functioning between MDD and SCZ. Future longitudinal studies with larger sample sizes should be done for a better understanding about the associations between the factors and functioning.

Outcomes of a Rehabilitation Programme for Patients with Chronic Back Pain

1995 ◽  
Vol 58 (10) ◽  
pp. 435-438 ◽  
Author(s):  
Monica Moran ◽  
Jenny Strong
Keyword(s):  
Back Pain ◽  
Pain Intensity ◽  
Functional Capacity ◽  
Chronic Back Pain ◽  
Rehabilitation Programme ◽  
Therapeutic Interventions ◽  
Pain Disability ◽  
Perceived Pain ◽  
Disability Questionnaire ◽  
Objective Outcome

In order to evaluate the effectiveness of a rehabilitation programme for patients with chronic back pain, data on the subjective outcomes of perceived pain intensity (as measured by the Visual Analogue Scale Horizontal) and perceived level of disability (as measured by the Oswestry Low Back Pain Disability Questionnaire), and the objective outcome of functional capacity (as measured by the West Standardised Evaluation), were collected on 51 subjects prior to entry into a back pain rehabilitation programme and at discharge. The results at discharge showed a significant reduction in the perceived level of disability and a significant Increase in the functional capacity. The perceived pain intensity did not change significantly. The discussion focuses on the importance of directing therapeutic interventions towards increasing physical function rather than concentrating on the reduction or elimination of pain.

scholarly journals Psychological Profile and Consumption of Healthcare Resources in Actively Employed People, Pre-Retirees, and Retirees

2021 ◽  
Vol 13 (8) ◽  
pp. 4415
Author(s):  
Antonio Taboada-Vazquez ◽  
Ruben Gonzalez-Rodriguez ◽  
Manuel Gandoy-Crego ◽  
Miguel Clemente
Keyword(s):  
Mental Health ◽  
Employment Status ◽  
Social Stigma ◽  
Health Resources ◽  
Personality Tests ◽  
Healthcare Resources ◽  
Personality Variables ◽  
Promotion Policies ◽  
The Social ◽  
Logistic Regressions

Research on personality variables and consumption of health services in actively employed people or retirees has been extensive, but the group of pre-retirees has hardly been studied. This work attempts to determine the mental health and use of health resources of the three groups, hypothesizing that, as the group of pre-retirees does not receive the social stigma of work exclusion, it will present better mental health. A sample of 1332 Spanish participants aged between 51 and 69 years was randomly chosen, and various personality tests were applied, and consumption of healthcare resources was determined. Pairwise analysis of the three work situations using binary logistic regressions showed that pre-retirees present better mental health, although there were no differences in the consumption of healthcare resources. The implications of this study for the creation of health promotion policies targeting older people, depending specifically on their employment status, are discussed.

scholarly journals Investigating Cognitive and Clinical Predictors of Real-Life Functioning, Functional Capacity, and Quality of Life in Individuals at Ultra-High Risk for Psychosis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Louise Birkedal Glenthøj ◽  
Tina Dam Kristensen ◽  
Christina Wenneberg ◽  
Carsten Hjorthøj ◽  
Merete Nordentoft
Keyword(s):  
Quality Of Life ◽  
Social Skills ◽  
High Risk ◽  
Functional Capacity ◽  
Processing Speed ◽  
Negative Symptoms ◽  
Role Functioning ◽  
Functional Impairments ◽  
Ultra High Risk

Abstract A substantial proportion of individuals at ultra-high risk (UHR) for psychosis show long-term functional impairments, which may have profound consequences for the individual and society. Finding predictors of these functional impairments is critical to inform on the individual’s functional prognosis and potentially develop targeted interventions. This study used data from 91 UHR individuals participating in a randomized, clinical trial, that were followed up at 12 months, to elucidate on clinical, neuro- and social-cognitive predictors of UHR individuals’ functional outcome in the domains of social- and role functioning, quality of life, and functional capacity. The proportion of UHR individuals showing a poor social- and role outcome at 12-month follow-up was 50% and 63%, respectively. Worse social outcome was predicted by higher levels of negative symptoms, reduced processing speed, and impaired baseline social functioning explaining 52% of the variance. Worse role outcome was predicted by impaired role functioning at baseline, explaining 25% of the variance. Quality of life impairments were predicted by better theory of mind explaining 4% of the variance, and functional capacity social skills deficits were predicted by impaired baseline social skills explaining 20% of the variance. Our findings indicate that processing speed and negative symptoms may contribute to social- and role-functioning deficits, and while aspects of social cognition may also relate to social- and role functioning, baseline-functional impairments seem to be a strong contributor to persistent impairments in functioning and quality of life. If replicated, our findings suggest the need for future studies investigating the effect of pro-functional interventions targeting baseline functioning and targeted cognitive domains in UHR.

scholarly journals S121. REAL-WORLD FUNCTIONING IN SCHIZOPHRENIA: NEGATIVE SYMPTOMS AS A BRIDGE IN PATHWAYS FROM NEUROCOGNITION, SOCIAL COGNITION, AND FUNCTIONAL COMPETENCE

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S352-S353
Author(s):  
Tanya Tran ◽  
Pamela DeRosse ◽  
Katherine Burdick ◽  
Anil Malhotra ◽  
Tarindi Welikala ◽  
...  
Keyword(s):  
Social Cognition ◽  
Real World ◽  
Negative Symptoms ◽  
Functional Competence

scholarly journals P435 Real-world clinical outcomes after elective discontinuation of first-use biologics in IBD patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S395-S396
Author(s):  
U N Shivaji ◽  
A Bazarova ◽  
T Critchlow ◽  
O M Nardone ◽  
S C Smith ◽  
...  
Keyword(s):  
Real World ◽  
Adverse Outcomes ◽  
Machine Learning Technique ◽  
Tertiary Referral Centre ◽  
Kaplan Meier ◽  
Learning Technique ◽  
Logistic Regressions ◽  
The Uk ◽  
Almost All

Abstract Background In real-world clinical practice, biologics may be discontinued due to variety of reasons, including discontinuation by gastroenterologists, in the UK. The aim of the study was to report on outcomes after discontinuation in IBD patients after a minimum follow-up of 24 months. Methods All IBD patients who discontinued their first-use biologics between January 2013 and Dec 2016 were identified from the EMR at a tertiary referral centre to ensure at least 24 months follow-up. Reasons for discontinuation and pre-defined adverse outcomes (steroid and other rescue therapies, hospitalisations, surgery including perianal) were recorded. The data were analysed using multivariable and univariable logistic regressions within a machine learning technique in order to predict adverse outcomes within the stated timeframe. We performed Kaplan-Meier survival analysis for those patients who had biologics electively discontinued. Results In total, 147 IBD patients who discontinued biologics (M = 74.median age 39 years; CD = 110) were identified. Follow-up ranged from 24 to 60 months (median 40 months). One hundred and forty-four patients (98%) discontinued anti-TNF (1% biosimilar anti-TNF and 1% vedolizumab) and 69 (47%) were on thiopurines at start of biologics. Fifty-nine patients (40%) had biologics electively discontinued by their gastroenterologists and they were analysed separately. Of the 59 elective discontinuations, 22(37%) continued thiopurines after biologic stoppage; 37/59 (63%) patients had at least one adverse outcome (AO) within 6 months of discontinuation and 42/59 (71%) patients restarted biologics. Conclusion The majority of patients who electively discontinued biologics had IBD-related AO rapidly after the stoppage and needed to restart biologics. Almost all patients had AO by the end of the study follow-up period. This should be discussed with patients when considering discontinuation of biologics.

Sign in / Sign up

Export Citation Format

Share Document