Abstract
BackgroundPeople with schizophrenia demonstrate deficits in insight and the ability to self-evaluate their functioning. Research about patients’ ability to recognize their psychotic symptoms is well established, but recent findings show that there are still unexplored fields regarding how patients perceive their level of functioning A previous study showed that patients who overestimate their functioning, also consistently get high scores in interview-based assessment regarding real-world functional performance. The possible consequences of patients’ ability to correctly estimate their function need to be further investigated. The aim of the present study was to examine how the perception of one’s own capacity relate to symptoms in patients with schizophrenia spectrum disorders.MethodsData collection took place within the ongoing project Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which examines psychiatric outpatients. In this study, 222 patients with schizophrenia participated. They were divided into four groups based on their results on the UPSA-B and their self-perceived function; two groups with ordinary function (accurate estimators and under -estimators) and two groups with low function (accurate estimators and over-estimators). The groups were compared regarding psychiatric symptoms, examined using the Positive and Negative Syndrome Scale (PANSS). Non-parametric statistics were used to analyze differences in their symptoms.ResultsThere were statistically significant differences in the total score of PANSS across the four groups of function. The following analyses showed significant differences in the negative and general domain. Results from the post hoc examination revealed identical patterns in these two symptom domains. The group with Low function accurate estimators have significantly more severe symptoms compared to the other three groups.DiscussionThe result in the present study showed that patients with low function who overestimate their function have less or the same level of symptoms as patients in the two groups with ordinary functioning. In further studies it is important to investigate if this actually is a result of lower symptom level or if it is due to the impaired insight. This is important since the result in the present study mirror previous results where patients who overestimate a low function also, by clinicians, will be perceived as patients with a higher capacity and less difficulties.
Highlights
Negative symptoms represent a core feature of schizophrenia
The present study aimed to examine the construct validity of BNSS, by using convergent and divergent validities as well as factor analysis, in a Brazilian sample of 111 outpatients diagnosed with schizophrenia by DSM-5
The study shows that the Brazilian version of the BNSS has adequate psychometric properties and it is a reliable instrument for the assessment of negative symptoms in schizophrenia, either for clinical practice or research
Summary
Negative symptoms represent a core feature of schizophrenia. They have been associated to poor functional outcome, worse quality of life and poor response to pharmacological treatment. It is important to explore how other interpersonal or social factors may affect paranoia Neighborhood characteristics, such as reduced social cohesion and crime, perceived rejection, and loneliness have been associated with paranoia (Lamster, Nittel, Rief, Mehl, & Lincoln, 2017; Newbury et al, 2017; Wickham, Taylor, Shevlin, & Bentall, 2014). Methods: The current study will examine how paranoia correlates with neighborhood characteristics, loneliness, perceived rejection, and social network size in a transdiagnostic sample with psychosis. Using the Positive and Negative Syndrome Scale (PANSS), Conceptual disorganization’ (P2), ‘Difficulty in abstract thinking’ (N5) and ‘Poor attention’ (G11) were core features of the disorganization factor. The overlap of these items with neurocognitive functions is still debated. The observed association of Alpha with ‘Difficulty in abstract thinking’ suggests that some aspects of disorganization could be underpinned by the impairment of basic neurobiological functions that are only partially evaluated using MCCB
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