Abstract
Background: Recovery has become a priority in schizophrenia spectrum disorders (SSDs). This study aimed to investigate predictors of objective—general functioning and disability—and subjective—quality of life (QoL)—measures of functional outcomes in SSD. Methods: Sample: n = 77 SSD outpatients (age 18–64, IQ > 70) participating in a randomised controlled trial. Baseline data were used to build three multivariable linear regression models on: (i) general functioning—General Assessment of Functioning (GAF); (ii) disability—the World Health Organization Disability Assessment Schedule (WHODAS-2.0); and (iii) QoL—Satisfaction Life Domains Scale (SLDS). Results: Young age and being employed (R2 change = 0.211; p = 0.001), late adolescence premorbid adjustment (R2 change = 0.049; p = 0.0050), negative symptoms and disorganization (R2 change = 0.087; p = 0.025) and Theory of Mind (R2 change = 0.066, p = 0.053) predicted general functioning. Previous suicidal behaviour (R2 change = 0.068; p = 0.023) and negative and depressive symptoms (R2 change = 0.167; p = 0.001) were linked with disability. Previous suicidal behaviour (R2 change = 0.070, p = 0.026), depressive symptoms (R2 change = 0.157; p < 0.001) and illness recognition (R2 change = 0.046, p = 0.044) predicted QoL. Conclusions: Negative, disorganization and depressive symptoms, older age, unemployment, poor premorbid adjustment, previous suicide attempts and illness awareness appear to underlie a poor global functional outcome in SSD. Achieving recovery in SSD appears to require both symptomatic remission (e.g., through antipsychotics) and measures to improve mastery and relieve low mood.
Highlights
Schizophrenia spectrum disorders (SSDs) are highly frequent across the world
We conducted this cross-sectional study based on data from an randomised controlled trial (RCT) with SSD outpatients, aimed to investigate the contribution of clinical and cognitive insight, Jumping to Conclusions (JTC) and Theory of Mind (ToM) to three measures of functional outcome, namely general functioning, disability and quality of life (QoL), whilst adjusting for a set of demographic, clinical, neurocognitive and psychopathological variables
Consistent with our first hypothesis, we found that an overall measure of general functioning, such as the General Assessment of Functioning (GAF) score, was predicted by age, good premorbid adjustment, in late adolescence, less severe disorganization and negative symptoms and better ToM performance
Summary
Schizophrenia spectrum disorders (SSDs) are highly frequent across the world. SSDs remain associated with significant disability, worse quality of life (QoL) and higher mortality rates compared with the general population [2]. Current guidelines recommend that all patients should be offered cognitive behavioural therapy and family intervention in addition to antipsychotics [5]. Recovery has become a priority in schizophrenia spectrum disorders (SSDs). Baseline data were used to build three multivariable linear regression models on: (i) general functioning—General Assessment of Functioning (GAF); (ii) disability—the World Health Organization Disability Assessment Schedule. P = 0.0050), negative symptoms and disorganization (R2 change = 0.087; p = 0.025) and Theory of. Previous suicidal behaviour (R2 change = 0.068; p = 0.023) and negative and depressive symptoms (R2 change = 0.167; p = 0.001)
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