Department of Psychology, Queen's University, 62 Arch Street, Kingston, ON K7L 3N6, Canada.
J Psychiatr Res. 2012 Feb;46(2):205-11. doi: 10.1016/j.jpsychires.2011.09.002. Epub 2011 Sep 22.
A problem in the study and treatment of functional disability in schizophrenia is that factors other than competence (what one can do) can limit real-world performance (what one does). We examined predictors of the competence-performance discrepancy in both adaptive and interpersonal domains. Patients with schizophrenia (N = 96) were evaluated at baseline of a clinical treatment study. Discrepancy scores were created by considering each subject's competence relative to their real-world performance in interpersonal and adaptive behaviour domains. Logistic regression analyses revealed that for the interpersonal competence-performance discrepancy, living in a group home, better neurocognition, more time spent in the hospital since a first episode of psychosis, and a longer first hospitalization predicted a greater discrepancy between interpersonal competence and performance measures. For adaptive behaviour, shorter time since most recent hospitalization, more depressive symptoms, greater number of months of first hospitalization, older age at baseline, younger age at first hospitalization, and more time spent in the hospital since a first episode of psychosis predicted a greater adaptive competence-performance discrepancy. A different pattern of demographic and clinical features may limit the extent to which patients are deploying interpersonal versus adaptive skills in everyday life.
精神分裂症患者的功能障碍在研究和治疗上面临的一个问题是，除了能力（一个人能做什么）之外，还有其他因素会限制其在现实生活中的表现（一个人做了什么）。我们研究了在适应和人际交往领域中，导致能力与表现差异的预测因素。96 名精神分裂症患者参加了一项临床治疗研究，在研究的基线期接受了评估。通过考虑每个患者在人际交往和适应行为领域的相对能力与现实世界表现，得出了差异评分。逻辑回归分析显示，对于人际交往能力与表现的差异，居住在集体之家、认知功能更好、从精神病首次发作到现在住院时间更长、首次住院时间更长，这些因素都预示着人际交往能力与表现之间的差异更大。对于适应行为，最近一次住院时间较短、抑郁症状更严重、首次住院时间更长、在精神病首次发作后到现在住院时间更长、基线期年龄更大、首次住院年龄更小，这些因素预示着适应能力与表现之间的差异更大。不同的人口统计学和临床特征模式可能会限制患者在日常生活中运用人际交往技能和适应技能的程度。
