Pathways to functional outcome in subjects with schizophrenia living in the community and their unaffected first-degree relatives

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• 作者：Silvana Galderisi^a ; ^{silvana.galderisi@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Alessandro Rossi^b ; Paola Rocca^c ; Alessandro Bertolino^d ; Armida Mucci^a ; Paola Bucci^a ; Paola Rucci^e ; Dino Gibertoni^e ; Eugenio Aguglia^f ; Mario Amore^g ; Giuseppe Blasi^d ; Anna Comparelli^h ; Massimo Di Giannantonioⁱ ; Arianna Goracci^j ; Carlo Marchesi^k ; Palmiero Monteleone^l ; Cristiana Montemagni^c ; Federica Pinna^m ; Rita Ronconeⁿ ; Alberto Siracusano^o ; Paolo Stratta^b ; Maria Chiara Torti^p ; Antonio Vita^q ; Patrizia Zeppegno^r ; Marcello Chieffi^a ; Mario Maj^a ; Italian Network for Research on Psychoses¹
• 关键词：Schizophrenia first-degree relatives ; Interpersonal relationships ; Work skills ; Avolition ; Cognition ; Structural equation model
• 刊名：Schizophrenia Research
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：175
• 期：1-3
• 页码：154-160
• 全文大小：472 K

文摘

Variables influencing real-life functioning have repeatedly been modeled in schizophrenia subjects but not systematically investigated in their unaffected first-degree relatives (SRs), in whom milder forms of deficits reported in schizophrenia have been observed, but confounders of clinical cohorts are not in play. Demonstrating that pathways to functional outcome are similar between patients and SRs would validate structural models developed in schizophrenia subjects. The present multicenter study aimed to explore whether variables associated with real-life functioning are similar in schizophrenia patients and their unaffected relatives.

Methods

The study sample included 921 schizophrenia patients, 379 SRs and 780 healthy controls. Structural Equation Models (SEMs) were used in patients and SRs to test associations of psychopathological dimensions, neurocognition, social cognition, resilience, perceived stigma and functional capacity with real-life functioning domains, impaired in both patients and SRs.

Results

Interpersonal Relationships and Work Skills were the only functional domains impaired in both patients and SRs. For both domains, functional impairment in patients was found to predict impairment in unaffected relatives, suggesting the involvement of similar illness-related vulnerability factors. In both groups variables significantly associated with Interpersonal Relationships included Social Cognition, Neurocognition, Avolition, Resilience, Disorganization, Perceived Stigma and Gender, and those significantly associated with Work Skills included Social Cognition, Neurocognition and Disorganization.

Conclusions

Pathways to functional outcome for Interpersonal relationships and Work skills are similar between schizophrenia patients and their unaffected first-degree relatives. These findings validate, in the absence of confounders of clinical cohorts, structural models of determinants of functional outcome in people with schizophrenia.