Instrumental Activities of Daily Living Dysfunction among People with Schizophrenia

Abstract

Background: Life skills are the basic skills that are needed to live independently and that support meaningful, productive roles. The negative symptoms and cognitive dysfunction seen in schizophrenia may lead to deterioration in the life skills of the patient. The assessment of current life skills of the patient and subsequent intervention becomes necessary for comprehensive rehabilitation of people with mental illness. This study attempted to assess the instrumental activities of daily living among people with schizophrenia in India. Methods: One hundred consecutive patients with schizophrenia, between 18 and 60 years, who presented to a tertiary psychiatric facility were assessed using (i) Lawton instrumental activities of daily living scale (LIADL), (ii) positive and negative symptom scale (PANSS), (iii) pro forma for sociodemographic and clinical characteristics. Results: The majority of the patients were male, young adults, married, with secondary school education, middle socioeconomic status, from nuclear families, unemployed and were diagnosed to have paranoid schizophrenia. The reported IADL dysfunction included difficulties in handling medications (86%), preparing food (85%), shopping (78%), handling finances (61%), doing laundry (52%), housekeeping (47%), using public transport (32%), and using telephones (5%). The dysfunction documented differs from that reported in the west. Total PANSS score ( P = 0.015) and its general psychopathology subscale ( P = 0.005) correlated inversely with the total LIADL score; PANSS scores and sociodemographic variables were associated with some subscales of LIADL. Conclusions: IADL dysfunction, common in people with schizophrenia, demands detailed assessment, and tailored training to ensure optimum functioning.

Limited changes in activities of daily life performance ability among people with schizophrenia at clinical settings and the factors moderating the changes

“…Impaired functioning affecting multiple domains, including activities of daily living (ADL), is common among people with schizophrenia (Harvey and Bellack, 2009; Harvey et al, 2012; Samuel et al, 2018) and sustained recovery in functioning occurs in <15% of this population (Jääskeläinen et al, 2013). Community functioning in people with schizophrenia is likely to be determined by a complex array of factors including the severity of symptoms, cognitive deficits, and psychosocial disadvantages and disincentives (Bechi et al, 2017; Gupta et al, 2012; Harvey and Strassnig, 2012; Leifker et al, 2009; Lepage et al, 2014; Lin et al, 2013; Reichenberg et al, 2014).…”

Development and validation of Vellore Inventory of Life Skills among people with severe mental illness

“…The lack of correlation between the VILS and BPRS scores can imply that life skills dysfunction can be present irrespective of the severity of illness; this finding is similar to a previous study done at the same center. [ 3 ]…”

“…[ 2 ] Interventions targeting optimal independent functioning have been found to be essential for re-integration of persons with mental illness. [ 3 ] Failure to focus on independent living skills is also thought to increase family burden and economic disadvantage. [ 4 ]…”

Cognitive Remediation in Virtual Environments for Patients with Schizophrenia and Major Depressive Disorder: A Feasibility Study

“…VEs enable us to create an authentic, complex, and safe environment for assessment and training while preserving full control over the situation [32]. Furthermore, VEs can simulate so-called activities of daily living (ADLs), e.g., shopping, cooking, navigating, which are typically impaired in patients with schizophrenia [33]. The rehabilitation tasks' resemblance to real-life conditions can itself lead to enhanced ecological validity [34] and therefore facilitate the transfer of the gained abilities into everyday functioning [35].…”