Escobedo-Aedo Paula Jhoana, Forjan-González Ana, Sánchez-Escribano Martínez Adela, Ruiz-Ruano Verónica González, Sánchez-Alonso Sergio, Mata-Iturralde Laura, Muñoz-Lorenzo Laura, Baca-García Enrique, David Anthony S, Lopez-Morinigo Javier-David
Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain.
Departamento de Psiquiatría, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
Behav Sci (Basel). 2022 Jan 27;12(2):28. doi: 10.3390/bs12020028.
Recovery has become a priority in schizophrenia spectrum disorders (SSDs). This study aimed to investigate predictors of objective-general functioning and disability-and subjective-quality of life (QoL)-measures of functional outcomes in SSD.
Sample: = 77 SSD outpatients (age 18-64, IQ > 70) participating in a randomised controlled trial. Baseline data were used to build three multivariable linear regression models on: (i) general functioning-General Assessment of Functioning (GAF); (ii) disability-the World Health Organization Disability Assessment Schedule (WHODAS-2.0); and (iii) QoL-Satisfaction Life Domains Scale (SLDS).
Young age and being employed (R change = 0.211; = 0.001), late adolescence premorbid adjustment (R change = 0.049; = 0.0050), negative symptoms and disorganization (R change = 0.087; = 0.025) and Theory of Mind (R change = 0.066, = 0.053) predicted general functioning. Previous suicidal behaviour (R change = 0.068; = 0.023) and negative and depressive symptoms (R change = 0.167; = 0.001) were linked with disability. Previous suicidal behaviour (R change = 0.070, = 0.026), depressive symptoms (R change = 0.157; < 0.001) and illness recognition (R change = 0.046, = 0.044) predicted QoL.
Negative, disorganization and depressive symptoms, older age, unemployment, poor premorbid adjustment, previous suicide attempts and illness awareness appear to underlie a poor global functional outcome in SSD. Achieving recovery in SSD appears to require both symptomatic remission (e.g., through antipsychotics) and measures to improve mastery and relieve low mood.
康复已成为精神分裂症谱系障碍（SSDs）的首要任务。本研究旨在调查SSD中客观总体功能、残疾以及主观生活质量（QoL）等功能结局指标的预测因素。
样本：77名参与随机对照试验的SSD门诊患者（年龄18 - 64岁，智商>70）。基线数据用于建立三个多变量线性回归模型，分别针对：（i）总体功能——功能总体评估（GAF）；（ii）残疾——世界卫生组织残疾评估量表（WHODAS - 2.0）；以及（iii）生活质量——生活领域满意度量表（SLDS）。
年轻和就业状态（R变化 = 0.211；P = 0.001）、青春期后期病前适应情况（R变化 = 0.049；P = 0.0050）、阴性症状和紊乱症状（R变化 = 0.087；P = 0.025）以及心理理论（R变化 = 0.066，P = 0.053）可预测总体功能。既往自杀行为（R变化 = 0.068；P = 0.023）以及阴性和抑郁症状（R变化 = 0.167；P = 0.001）与残疾相关联。既往自杀行为（R变化 = 0.070，P = 0.026）、抑郁症状（R变化 = 0.157；P < 0.001）以及疾病认知（R变化 = 0.046，P = 0.044）可预测生活质量。
阴性、紊乱和抑郁症状、年龄较大、失业、病前适应不良、既往自杀未遂以及疾病意识似乎是SSD中总体功能结局不佳的潜在因素。实现SSD的康复似乎既需要症状缓解（例如通过抗精神病药物），也需要采取措施提高掌控感并缓解低落情绪。
