The association of psychopathology with concurrent level of functioning and subjective well-being in persons with schizophrenia spectrum disorders

Abstract

The objective is to investigate the relationship between psychopathology measured by the positive and negative syndrome scale (PANSS) and concurrent global assessment of functioning (GAF) and subjective well-being under neuroleptics (SWN) in patients with schizophrenia spectrum disorder (SSD) regarding severity of illness and disease phase. We analyzed a sample of 202 SSD patients consisting of first episode psychosis (FEP) and multiple episode psychosis (MEP) patients followed up to 12 months using linear mixed models. All PANSS syndromes except excitement were associated with GAF scores (positive syndrome: p < 0.001, d = 1.21; negative syndrome: p = 0.029, d = 0.015; disorganized syndrome: p < 0.001, d = 0.37; anxiety/depression syndrome: p < 0.001, d = 0.49), and positive symptoms had an increasing impact on global functioning with higher severity of illness (mildly ill: p = 0.039, d = 0.22; moderately ill: p < 0.001, d = 0.28; severely ill: p < 0.001, d = 0.69). SWN was associated with positive (p = 0.002, d = 0.22) and anxiety/depression (p < 0.001, d = 0.38) syndromes. Subgroup analyses showed differing patterns depending on illness severity and phase. Over all our results show different patterns of associations of psychopathology and concurrent functioning and subjective well-being. These findings contribute knowledge on the possible role of specific psychopathological syndromes for the functioning and well-being of our patients and may enable tailored treatments depending on severity and phase of illness.

Validation and Optimal Cut-Off Score of the World Health Organization Well- being Index (WHO-5) as a Screening Tool for Depression among Patients with Schizophrenia

“…Second, and consistent with the same study, measurement invariance of the WHO-5 was established between male and female patients, implying that no differential item functioning exists for sex [27]. Third, the concurrent validity ndings revealed that WHO-5 scores were positively correlated with levels of functioning, and inversely correlated with anxiety and depression symptoms' severity, thereby con rming the ndings of earlier research studies [69][70][71]. Altogether, our psychometric ndings were in line with the limited existing literature.…”

Latent state-trait structure of BPRS subscales in clinical high-risk state and first episode psychosis

“…As an example, the representatives name the drastically decreased number of cases diagnosed with hebephrenia, while the borderline personality disorder diagnosis increased since the ICD-10 was introduced, hinting on a degree of arbitrariness of the current operationalization of schizophrenia spectrum disorders 56 . Furthermore, there is evidence that psychopathology is not necessarily related to an impairment in subjective wellbeing: a study examining individuals with first episode psychosis showed no associations between subjective wellbeing and the PANSS subscales Negative Symptoms, Positive Symptoms, Disorganization and Excitement 24 , supporting a rather resource-oriented point of view and discouraging a perspective focused on residual symptoms. Following this line of thought, our results could provide a basis to disentangle the heterogeneity in the psychopathological presentation of schizophrenia-spectrum disorders and for the investigation of endophenotypes linked to risk factors and biological correlates 57 .…”

“…For a more detailed description of the in- and exclusion criteria see Riecher-Rössler et al (2007 and 2009) 16 , 23 and Hochstrasser et al (2017) 24 .…”