Psychosocial function in schizophrenia and bipolar disorder: Relationship to neurocognition and clinical symptoms

Abstract

In line with a dimensional approach to psychopathology, we examined whether psychosocial function and its relationship to neurocognition and clinical symptoms differ across schizophrenia and bipolar disorder subgroups with and without a history of affective or psychotic episodes. From the TOP study, a heterogeneous sample of individuals with schizophrenia spectrum disorders without (n = 60) and with a history of affective episodes (n = 54); individuals with bipolar spectrum disorders with (n = 64) and without a history of psychosis (n = 56) and healthy controls (n = 268) participated. Psychosocial functioning was measured with the Social Functioning Scale (self-rated) and the Global Assessment of Functioning Scale (clinician-rated), neurocognition with a comprehensive neuropsychological test battery, and symptoms with Inventory of Depressive Symptomatology, Young Mania Rating Scale, and Positive and Negative Syndrome Scale. Clinician-rated functioning was poorer in schizophrenia groups than in bipolar groups, but self-rated functioning was similar across all clinical groups and poorer than in controls. Neurocognition and current clinical symptoms were associated with psychosocial function in bivariate analyses, but current symptoms had a greater independent contribution to functioning than neurocognition across clinical groups in multivariate analyses. Despite differences in neurocognition and psychosocial function, groups showed the same pattern in prediction of functioning irrespective of DSM-IV or clinical definition.

Psychometric properties of the self-report version of the Quick Inventory of Depressive Symptoms (QIDS-SR16) questionnaire in patients with schizophrenia

“…Although there was some overlap, the QIDS-SR 16 discriminated depressive symptoms from negative symptoms in an acceptable way, in line with previous work on the full 30-item Inventory of Depressive Symptoms (IDS) in a mixed population of patients with schizophrenia and bipolar disorder [41]. In addition, a latent factor for negative symptoms was not identified for the QIDS-SR 16 , despite that several items overlap with negative symptoms, such as of concentration difficulties (question #10), lack of interest (#13) and lack of energy (#14).…”

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

“…Quality of life is reduced in both symptomatic and non‐symptomatic patients when compared to healthy controls,15, 16, 17 and several domains of functioning have been identified by patients as being of particular importance‐ including physical, sleep, mood, cognition, leisure, social, spirituality, finances, household, self‐esteem, independence, identity, work, and education 18. For both psychosocial functioning and quality of life, impairments are more pronounced in patients with depressive symptoms,19, 20, 21 in those with more previous episodes/longer duration of illness,20, 22 and in those with lower cognition 23…”

Negative affect predicts social functioning across schizophrenia and bipolar disorder: Findings from an integrated data analysis

“…However, refractory symptoms along with broad cognitive deficits (e.g., cognitive deficits such as working memory and social cognitive deficits that include impaired Theory of Mind), and negative symptoms (e.g., lack of motivation) often remain (Abi-Dargham, 2014; Dodell-Feder et al, 2015). Impaired cognitive abilities and amotivation may lead to difficulties engaging in social roles (Lincoln et al, 2011) and substantial evidence indicates that these deficits and symptoms are predictive of poor social functioning in SZ and BD (Atre-Vaidya et al, 1998; Couture et al, 2006; Fett et al, 2011; Green et al, 2004; Palisoc et al, 2014; Simonsen et al, 2010; Strauss et al, 2012; Tabares-Seisdedos et al, 2008), even more so than psychotic (Strassnig et al, 2015) and manic symptoms (Bas et al, 2015; Tabares-Seisdedos et al, 2008). However, cognition and negative symptoms together account for a small portion of the variance in outcomes (Tabares-Seisdedos et al, 2008).…”