Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms
Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms
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DOI：
10.1176/appi.ajp.163.3.418
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发表时间：
2006-03-01
影响因子：
17.7
通讯作者：
Harvey, PD
中科院分区：
文献类型：
--
作者：
Bowie, CR;Reichenberg, A;Harvey, PD
目的：精神分裂症患者的适应性生活技能障碍是导致残疾的主要原因。现实生活中的适应性生活技能与神经心理测试的表现之间的关系可能会因其他干扰技能部署的因素而变得复杂。评估在最佳条件下执行生活技能的能力（即，功能能力的评估）已被提出作为一种手段，以澄清这些relationships.Method：作者检查了横断面数据从一项研究的过程中的神经心理和适应性生活技能的老年人（年龄50-85）精神分裂症患者（N=78）。功能能力是用基于性能的测量（UCSD基于性能的技能评估）进行检查的，案例经理对现实世界的适应功能进行评级（即，人际交往技能、工作技能和社群活动）。神经心理学性能进行了评估与一个全面的电池，而症状进行了评估与患者的自我报告和临床ratings.Results：症状路径分析被用来评估神经心理学性能，功能能力，和症状的影响，在现实世界的功能的各个领域。神经心理学表现预测了功能能力，功能能力预测了现实世界功能的所有三个领域。抑郁症预测的人际关系和工作技能，而负面症状影响的人际关系技能独立于其他predictors.Conclusions：现实世界的适应性生活技能预测的神经心理表现，症状和功能能力。在考虑了功能能力后，神经心理学表现对现实世界表现的预测贡献不大。在某些领域，消极和抑郁症状影响现实世界的表现，而不涉及功能能力或神经心理性能。
Objective: Impairments in adaptive life skills are a major source of disability in patients with schizophrenia. The relationship between adaptive life skills in realworld settings and performance on neuropsychological tests may be complicated by other factors that interfere with deployment of skills. Assessment of the ability to perform life skills under optimal conditions (i.e., assessment of functional capacity) has been proposed as a means to clarify these relationships.Method: The authors examined cross-sectional data from a study of the course of neuropsychological and adaptive life skills of older (age 50-85) schizophrenia patients (N=78). Functional capacity was examined with a performance-based measure (UCSD Performance-Based Skills Assessment), and case managers rated realworld adaptive functions ( i.e., interpersonal skills, work skills, and community activities). Neuropsychological performance was assessed with a comprehensive battery, while symptoms were assessed with patient self-report and clinical ratings.Results: Confirmatory path analyses were used to evaluate the effects of neuropsychological performance, functional capacity, and symptoms on the various domains of real-world functioning. Neuropsychological performance predicted functional capacity, which predicted all three domains of real-world functioning. Depression predicted interpersonal and work skills, while negative symptoms affected interpersonal skills independently of other predictors.Conclusions: Real-world adaptive life skills are predicted by neuropsychological performance, symptoms, and functional capacity. Neuropsychological performance contributes little to the prediction of real-world performance after accounting for functional capacity. In some domains, negative and depressive symptoms influenced real-world performance while not relating to functional capacity or neuropsychological performance.