Abstract
Patients with schizophrenia exhibit impairments in their social activity, intelligence quotient (IQ), daily living skills, and social function. Social activity is a high-order outcome measure of their lives. Here we attempted to longitudinally evaluate the effects of IQ, daily living skills, social function, psychiatric symptoms, and medications on social activity in patients with schizophrenia. The purpose of the current study is to identify the specific factor that affects longitudinal changes in social activity. Sixty-five patients with schizophrenia were assessed at two time points [time 2 (T2, follow-up) − time 1 (T1, baseline) = 1.71 ± 0.79 years]. Social activity, IQ, daily living skills, and social function were assessed using the Social Activity Assessment (SAA; h/week), short form of the Wechsler Adult Intelligence Scale (WAIS)-III (WAIS-SF), University of California San Diego (UCSD) Performance-Based Skills Assessment (UPSA), and Social Functioning Scale (SFS), respectively. IQ, daily living skills, social function, and social activity were significantly improved between T1 and T2 (t = 2.0–4.4, p = 0.048–3.60 × 10−5). IQ, daily living skills, and social function positively correlated with social activity (lowest p = 1.27 × 10−5), and psychiatric symptoms negatively correlated with social activity over time (lowest p = 3.26 × 10−9). The longitudinal change in social activity was independently and positively correlated with a change in social function (beta = 0.35, p = 4.63 × 10−3), particularly interpersonal communication (beta = 0.35, p = 4.32 × 10−3). The longitudinal changes in other factors did not directly affect the change in social activity (p > 0.05). Based on these findings, social activity is more affected by social function than by other factors.
Highlights
Social and occupational impairments are a long-recognized core feature of patients with firstepisode and chronic schizophrenia [1, 2]
We evaluated the contributions of cognitive function, daily living skills, social function, illness severity, and medications to social activity in patients with schizophrenia
The longitudinal change in social activity was positively correlated with the longitudinal changes in social function, interpersonal communication
Summary
Social and occupational impairments are a long-recognized core feature of patients with firstepisode and chronic schizophrenia [1, 2]. These impairments are linked to a wide range of factors, including symptoms such as delusions, hallucinations, blunted affect and withdrawal, cognitive impairments, decreased functional capacity, and real-life dysfunction, in patients with schizophrenia. Patients with schizophrenia spend less time on work, housework/ childcare, studying, and social and leisure activities compared to the general population [1, 18]. Social function is assessed as activity frequency in patients with schizophrenia using the Social Functioning Scale (SFS) [20], while the SFS does not capture the time spent in weekly social activity. Social activity, i.e., work hours per week (h/ week), may be a useful measure of further treatment evaluations or clinical assessments of recovery
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