Social dysfunction and skills in schizophrenia: relationship with treatment response and severity of psychopathology

Hélio Elkis,Silvia Scemes,Aline Roberta Da Silva,Zilda Del Prette,Paulo Mestriner,Mariangela Gentil Savoia

doi:10.1590/0101-60830000000095

Abstract

Social dysfunction is an important outcome for schizophrenia and can be measured by the evaluation of social skills. Objectives To compare social skills in patients with schizophrenia classified according the degree of treatment response and severity of psychopathology with normative controls by using the Del Prette Social Skills Inventory (SSI). Methods Cross-sectional study where the 38 questions SSI was applied to 62 outpatients with schizophrenia and compared with data of 99 normal controls from the general population. The SSI was evaluated by five domains. Psychopathology was measured by the Positive and Negative Syndrome Scale (PANSS). Patients were classified as Treatment Resistant (TRS) and Non Treatment Resistant (NTRS) by the International Psychopharmacology Algorithm Project (IPAP) criteria. ANCOVA was used to control for demographic differences between populations. Results Patients showed significantly more impaired than controls except for aggressiveness control. When variables such as age, age of onset, schooling or medication dose entered as covariates, differences between controls and patients, or TRS with NTRS, almost disappeared. The SSI and PANSS showed an inverse relationship between their domains. Discussion The SSI may represent a useful tool for evaluation of social skills in schizophrenia. Antipsychotics may exert a protective effect on social skills

Highlights

Schizophrenia is a severe mental disorder which affects 1% of the population and it is associated with personal, social and family burden
The present study found that, as expected, patients with schizophrenia, when compared with normal controls, show more pronounced impairments in various domains of social skills abilities as measured by the Skills Inventory (SSI) – Del-Prette inventory
Patients performed better than controls on the selfcontrol of aggressiveness (F5) which may be explained by the fact that antipsychotics exert control over aggression, clozapine[17] which was received by half of the sample of the patients

Summary

Introduction

Schizophrenia is a severe mental disorder which affects 1% of the population and it is associated with personal, social and family burden. Patients with schizophrenia are treated with antipsychotics, either or first or second generation, and are considered responders or nontreatment resistant (NTRS) when they improve certain symptoms (e.g. psychotic symptoms) after one or two adequate treatments. Patients with TRS are considered more severely compromised than those with NTRS3. Objectives: To compare social skills in patients with schizophrenia classified according the degree of treatment response and severity of psychopathology with normative controls by using the Del Prette Social Skills Inventory (SSI). Results: Patients showed significantly more impaired than controls except for aggressiveness control When variables such as age, age of onset, schooling or medication dose entered as covariates, differences between controls and patients, or TRS with NTRS, almost disappeared.

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Conclusion