Brasso C, Bellino S, Bozzatello P, Montemagni C, Rocca P
Departement of Neuroscience "Rita Levi Montalcini", University of Turin, Italy.
Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino", Turin, Italy.
Heliyon. 2024 Dec 18;11(1):e41332. doi: 10.1016/j.heliyon.2024.e41332. eCollection 2025 Jan 15.
Patients with schizophrenia (SZ) often experience difficulties and impairment in daily functioning. Various factors influence functional outcomes, such as the duration of illness (DOI), the intensity of symptoms, and cognitive impairments. This study aimed at assessing the total, direct, and indirect contribution of the DOI to three key areas of daily functioning for individuals with stable SZ: life skills, work abilities, and interpersonal relationships. Spearman's partial correlations, adjusted for age, gender, and education, were computed between the DOI, symptoms and cognitive variables, and the three real-life functioning domains. We performed three generalized linear mediation models, one for each selected domain of functioning as the dependent variable. Symptoms and cognitive variables significantly correlated with the DOI and at least one of the functioning domains were included in the mediation models as possible mediators between the DOI and the domain of real-life functioning with which they were correlated. The DOI was the independent variable in all models. Effects were computed in total, direct, indirect, and component-estimated forms. A p-value of < .05 was considered statistically significant. A longer DOI was associated with poorer everyday life and working skills, while no such link was found with interpersonal relationships. The negative effect of the DOI on everyday life and working skills was mediated by disorganization and metacognitive mastery and disorganization alone respectively. Early targeted interventions on disorganization and metacognitive mastery might lead to improvements in the functional outcomes of people living with SZ.
精神分裂症（SZ）患者在日常功能方面常常遇到困难并出现功能损害。多种因素会影响功能结局，如病程（DOI）、症状强度和认知障碍。本研究旨在评估病程对病情稳定的SZ患者日常功能三个关键领域的总体、直接和间接影响：生活技能、工作能力和人际关系。计算了在调整年龄、性别和教育因素后的DOI、症状及认知变量与三个现实生活功能领域之间的Spearman偏相关性。我们进行了三个广义线性中介模型，每个选定的功能领域作为一个模型的因变量。症状和认知变量与病程显著相关，且至少一个功能领域作为病程与它们相关的现实生活功能领域之间的可能中介因素纳入中介模型。病程在所有模型中均为自变量。效应以总体、直接、间接和成分估计形式计算。p值<0.05被认为具有统计学意义。较长的病程与较差的日常生活和工作技能相关，而在人际关系方面未发现此类关联。病程对日常生活和工作技能的负面影响分别由紊乱以及仅由紊乱和元认知掌握介导。针对紊乱和元认知掌握的早期靶向干预可能会改善SZ患者的功能结局。
