Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
Psychiatry Res. 2017 May;251:118-124. doi: 10.1016/j.psychres.2017.02.019. Epub 2017 Feb 9.
Impairment in daily functioning still represents a major treatment issue in schizophrenia and a more in-depth knowledge of underlying constructs is crucial for interventions to translate into better outcomes. This study aims to model factors influencing both functional capacity and real-life behaviour in a sample of outpatients with chronic schizophrenia, through a comprehensive assessment including evaluations of psychopathology, cognitive and social cognitive abilities, premorbid adjustment, family environment and early childhood experiences. No significant correlation was observed between functional capacity and real-life behaviour. Functional capacity was significantly predicted by IQ, while real-life behaviour was significantly predicted by empathy, affect recognition and symptoms. Functional capacity seems mainly related to neurocognition, whereas real-life behaviour appears more complex, requiring the integration of different factors including symptoms, with a major role of empathy. Results thus support a divergence between the two constructs of functioning and their underlying components and highlight the need to target both dimensions through individualized sequential rehabilitation programs in order to optimize functional outcome.
日常功能障碍仍然是精神分裂症的一个主要治疗问题，深入了解潜在结构对于干预措施转化为更好的结果至关重要。本研究旨在通过全面评估，包括精神病学评估、认知和社会认知能力、病前调整、家庭环境和幼儿期经历，来建立影响慢性精神分裂症门诊患者的功能能力和现实生活行为的因素模型。在功能能力和现实生活行为之间没有观察到显著相关性。功能能力显著受智商预测，而现实生活行为则显著受共情、情感识别和症状预测。功能能力似乎主要与神经认知有关，而现实生活行为则更加复杂，需要整合包括症状在内的不同因素，共情起着重要作用。因此，研究结果支持了两个功能结构及其潜在组成部分之间的差异，并强调需要通过个体化的序贯康复计划针对这两个维度进行治疗，以优化功能结果。
