Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder.
Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder.
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DOI：
10.1176/appi.ajp.2010.09101406
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Pulver AE
中科院分区：
文献类型：
--
作者：
Bowie CR;Depp C;McGrath JA;Wolyniec P;Mausbach BT;Thornquist MH;Luke J;Patterson TL;Harvey PD;Pulver AE
精神分裂症（SZ）和双相情感障碍（BD）与多维残疾有关。本研究检查了两种疾病之间功能缺陷的差异预测因素。在社区居住的SZ （N=161）或BD （N=130）患者接受了神经心理测试、症状测量、基于表现的社会和适应（即日常生活技能）功能能力测量，并对现实世界的功能领域进行了评分：1)社区和家庭活动，2)工作技能，3)人际关系。我们使用验证性路径分析来寻找最佳拟合模型，以检查现实世界功能的三个领域的直接和间接（由能力介导）预测。在两组的所有模型中，神经认知与结果的关系主要由能力介导。症状与结果呈负相关，但与能力无关，但抑郁除外，抑郁是双相障碍的直接和介导的（通过社会能力）预测因子。在两组中，神经认知与活动直接相关，并通过与适应能力的介导关系。SZ组的神经认知直接或间接（通过社会能力的中介）预测工作技能，BD组的神经认知完全由适应能力和社会能力介导。SZ组的神经认知与人际关系直接相关，两组均由社会能力介导。虽然在SZ中有更大的残疾，但神经认知预测两种疾病在所有结局领域的功能都更差。我们的研究支持双相障碍和SZ的神经认知在产生残疾中的共同作用，并在症状的领域特异性效应和社会和适应能力方面观察到障碍之间的预测性差异。
Schizophrenia (SZ) and Bipolar Disorder (BD) are associated with multidimensional disability. This study examined differential predictors of functional deficits between the disorders. Community dwelling individuals with SZ (N=161) or BD (N=130) were administered neuropsychological tests, symptom measures, performance-based social and adaptive (i.e., everyday-living skills) functional competence measures, and rated on domains of real-world functioning: 1) Community and Household activities, 2) Work skills, and 3) Interpersonal relationships. We used confirmatory path analysis to find the best fitting models to examine the direct and indirect (as mediated by competence) prediction of the three domains of real-world functioning. In all models for both groups, neurocognition’s relationship with outcomes was largely mediated by competence. Symptoms were negatively associated with outcomes but unassociated with competence, with the exception of depression, which was a direct and mediated (through social competence) predictor in BD. In both groups, neurocognition was related to Activities directly and through a mediated relationship with adaptive competence. Work Skills were directly and indirectly (through mediation with social competence) predicted by neurocognition in SZ and entirely mediated by adaptive and social competence in BD. Neurocognition was associated with Interpersonal Relationships directly in the SZ group, and mediated by social competence in both groups. Although there was greater disability in SZ, neurocognition predicted worse functioning in all outcome domains in both disorders. Our study supports the shared role of neurocognition in BD and SZ in producing disability, with predictive differences between disorders observed in domain-specific effects of symptoms and social and adaptive competence.
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影响因子：
5.3
作者：
Green, Michael F.
通讯作者：
Green, Michael F.
DOI：
10.1176/appi.ajp.2009.09010106
发表时间：
2009-07
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Harvey PD;Helldin L;Bowie CR;Heaton RK;Olsson AK;Hjärthag F;Norlander T;Patterson TL
通讯作者：
Patterson TL
影响因子：
7.2
作者：
Gildengers, Ariel G.;Butters, Meryl A.;Mulsant, Benoit H.
通讯作者：
Mulsant, Benoit H.
DOI：
10.1017/s1355617704102130
发表时间：
2004-05-01
影响因子：
2.6
作者：
Heaton, RK;Marcotte, TD;Grant, I
通讯作者：
Grant, I
影响因子：
11.3
作者：
CORNBLATT, BA;RISCH, NJ;ERLENMEYERKIMLING, L
通讯作者：
ERLENMEYERKIMLING, L