Relationship between clinical outcomes measures and personal and social performance functioning in a prospective, interventional study in schizophrenia

Abstract

Objectives: To explore clinical and demographic characteristics impacting patient functioning by determining extent of overlap in factors driving change in Personal and Social Performance (PSP) and other clinical outcomes. Methods: Post-hoc analysis from a single-arm trial of paliperidone extended release in adult patients with nonacute symptomatic schizophrenia. Psychosocial functioning measures: PSP, Clinical Global Impression-Severity (CGI-S), Positive and Negative Syndrome Scale (PANSS), Short-Form 36 (SF-36), treatment satisfaction, sleep quality/daytime drowsiness, and Extrapyramidal Symptoms Rating Scale. Results: Highest correlations with PSP total score change included PANSS total score change (Spearman's r ¼ 0.607), PANSS general psychopathology change (r ¼ 0.579), and CGI-S change (r ¼ 0.569). A PSP score change of À 32 predicted 90% probability of deterioration in CGI-S (score change of ≥1). The power of PSP change to predict PANSS total score change was lower. Linear stepwise regression demonstrated independent relationships for PSP change and: PANSS total change; CGI-S change; SF-36 Mental Component change; treatment satisfaction at endpoint; PSP at baseline; previous psychiatric hospitalizations. R 2 ¼ 0.55 meant that 45% of PSP variation could not be explained by other clinical outcome measures. Conclusions: Psychosocial functioning improvement is important in schizophrenia. PSP may be valuable for assessing functioning; it encompasses psychosocial and clinical factors not measured by other established assessments. K E Y W O R D S clinical outcomes, psychosocial functioning, schizophrenia Adapted from NCT00460512.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Comparison of Efficacy and Safety Between Low-Dose Ziprasidone in Combination With Sertraline and Ziprasidone Monotherapy for Treatment-Resistant Patients With Acute Exacerbation Schizophrenia: A Randomized Controlled Trial

“…When a cut-off value was set in the improvement of ≥6 points in PSP score, we also found a significant association between the improvements in CGI-S and PSP. These results were similar to previous prospective studies ( Vauth et al, 2020 ), suggesting that combination therapy might play a role by improving symptoms, increasing patient enthusiasm, enhancing patient communication ability, and increased participation in social activities. Previous studies also found that the psychiatric symptoms-like negative symptoms-were a predictor for social functioning ( Best et al, 2020 ).…”

Participant Engagement and Symptom Improvement: Aripiprazole Tablets with Sensor for the Treatment of Schizophrenia

“… 39–41 Associations have also been found between the PANSS and the CGI-I, the PANSS and the CGI-S, and the PSP and the CGI-S when evaluating clinical outcomes in people with schizophrenia. 40 , 42 , 43 This analysis found similar differences within and between groups for these scales, supporting that the results found here may be due to more than chance and are worth future consideration.…”

“…The PANSS and the PSP are not independent and have been shown to have correlated scores. [39][40][41] Associations have also been found between the PANSS and the CGI-I, the PANSS and the CGI-S, and the PSP and the CGI-S when 1 and Supplemental Table 2 for the full survey results and all means comparisons. a P-values were calculated using the Mann-Whitney U test.…”

A systematic review of the prognostic value of motor abnormalities on clinical outcome in psychosis

“…The other 23 studies related MAs to symptom severity measured on clinical evaluation scales: 13 of them, with samples ranging from 17 to 10,000, found a significant relationship between MAs and more severe positive, negative and/or overall symptom severity. This applies for elevated baseline scores of NSS (Behere, 2013;Fong et al, 2017;Mittal et al, 2007a;Sambataro et al, 2020), presence or development of tardive dyskinesia (Eberhard et al, 2006;Tenback et al, 2007;van Os et al, 2000), and/or (a combination of) other MAs, such as parkinsonism, akinesia, akathisia, dyskinesia, dystonia, and catatonia (L. Chen et al, 2013;Dollfus and Petit, 1995;Farreny et al, 2018;Peralta and Cuesta, 1999;Schennach-Wolff et al, 2011;Vauth et al, 2021). One study found results that indicated a relationship in the opposite direction between MAs and symptomatic outcome: an open-label trial with risperidone in 36 antipsychotic-naïve patients with schizophrenia significantly related development of parkinsonism to clinical improvement over five weeks (Venkatasubramanian et al, 2013).…”

“…Eight studies related MAs to social functioning and/or quality of life at follow-up. Six of these studies found that MAs, including NSS, dyskinesia, parkinsonism, akathisia and dystonia, were linked to poor (psycho)social functioning at follow-up (Ascher-Svanum et al, 2008;Behere, 2013;Chen et al, 2013;Fong et al, 2017;Park et al, 2016;Vauth et al, 2021). One study showed that akathisia scores contributed to poor general health on the six-dimensional health state short form (SF-6D) (Siani et al, 2016).…”