Prouteau A, Verdoux H, Briand C, Lesage A, Lalonde P, Nicole L et al. Cognitive predictors of psychosocial functioning outcome in schizophrenia: a follow-up study of subjects participations in a rehabilitation program. Schizophr Res 77: 343-353
Department of Social and Preventive Medicine, Laval University, Quebec City, Quebec, Canada Schizophrenia Research
(Impact Factor: 3.92).
10/2005; 77(2-3):343-53. DOI: 10.1016/j.schres.2005.03.001
The aims of this prospective study were to explore in subjects with psychosis participating in a rehabilitation program whether cognitive performances at baseline predicted (i) psychosocial functioning over a 15-16 month follow-up; (ii) improvement in psychosocial functioning over the rehabilitation program. Visuo-spatial tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered to assess cognitive performance in 55 subjects with schizophrenia spectrum disorders who completed a rehabilitation program. The Multnomah Community Ability Scale (MCAS) was used to measure dimensions of community functioning. One subscale of the Client's Assessment of Strengths, Interests, and Goals (CASIG) provided a measure of subjective quality of life (QoL). Improvement was defined as a 15% or more increase in psychosocial scores between baseline and follow-up. Worse baseline sustained attention predicted better self-rated quality of life, and better baseline visual memory predicted better community functioning over the rehabilitation follow-up period, in particular, higher autonomy in activities of daily living, and less physical and psychiatric symptoms that could interfere with rehabilitation. Baseline cognitive performances predicted community functioning improvement during the follow-up period: visual memory predicted improvement in daily living autonomy and in social competence; sustained attention predicted improvement in behavioral problems (such as medication compliance, collaboration with treatment providers or impulse control) and social competence; planning performances predicted improvement in social competence. These cognitive functions could be specifically targeted in a rehabilitation program aimed at enhancing functioning in those particular dimensions.
Available from: Katerina Sedlakova
- "Moreover, longitudinal studies suggest that the cognitive decline in late-life schizophrenia may first affect VIS abilities (Rajji and Mulsant, 2008). It was also demonstrated that VIS tasks related to attention, memory, and planning predict improvements on psychosocial functions, such as autonomy in daily living, treatment compliance, and social competence in subjects with psychosis (Prouteau et al., 2005). Given the significance of VIS functions in our daily life, it is expected that visuospatial tests would be good predictors of functional outcome in SZ. "
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Deficit in visuospatial functions can influence both simple and complex daily life activities. Despite the fact that visuospatial deficit was reported in schizophrenia, research on visuospatial functions as an independent entity is limited. Our study aims to elucidate the impact of visuospatial deficit in comparison with verbal deficit on global functioning and quality of life in the first psychotic episode of schizophrenia spectrum disorder (FES). The significance of clinical symptoms and antipsychotic medication was also studied.
Thirty-six FES patients and a matched group of healthy controls (HC group) were assessed with a neuropsychological battery focused on visuospatial (VIS) and verbal (VERB) functions. Using multiple regression analysis, we evaluated the cumulative effect of VERB and VIS functions, psychiatric symptoms (PANSS) and antipsychotic medication on global functioning (GAF) and quality of life (WHOQOL-BREF) in the FES group.
The FES group demonstrated significant impairment both in VIS and VERB cognitive abilities compared to the HC group. Antipsychotic medication did not significantly affect either VIS or VERB functioning. PANSS was not related to cognitive functioning, apart from the Trail Making Test B. In the FES group, the GAF score was significantly affected by the severity of positive symptoms and VERB functioning, explaining together 60% of GAF variability. The severity of negative and positive symptoms affected only the Physical health domain of WHOQOL-BREF. The degree of VERB deficit was associated with both Physical and Psychological health. Although we did not find any relation between VIS functioning, GAF, and WHOQOL-BREF, a paradoxical finding emerged in the Environment quality domain, where a worse quality of the environment was associated with better VIS functioning.
Our results suggest that the deficit in VIS functions is an integral part of cognitive deficit in schizophrenia spectrum disorders, rather than a side effect of symptomatology or antipsychotic medication. Moreover, VERB functioning was a better predictor of GAF and WHOQOL-BREF than VIS functioning. Given the findings of negative or missing effect of VIS deficit on WHOQOL-BREF and GAF, the accuracy of these measures in evaluating the impact of global cognitive deficit on everyday life in schizophrenia could be questioned.
Available from: Gustavo Silva
- "In the last decade, a body of research has been examining the effects of physical activity (PA) for people with schizophrenia (Bradshaw, Lovell, Bee, & Campbell, 2010; Fogarty & Happell, 2005; Knöchel et al., 2012). The regular practice of PA promotes benefits, such as the reduction of weight, body mass index (BMI), waist circumference, cholesterol, triglycerides, negative symptoms, as well as increasing mental health, cognitive functioning, physical and social functioning (Acil, Dogan, & Dogan, 2008; Attux et al., 2011; Duraiswamy, Thirthalli, Nagendra, & Gangadhar, 2007; Methapatara & Srisurapanont, 2011; Pelletier, Nguyen, Bradley, Johnsen, & McKay, 2005; Poulin et al., 2007; Prouteau et al., 2005; Van Citters et al., 2010). "
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The purpose of this study was to evaluate the effects of a 16-week group physical activity (PA) program on physical fitness and quality of life in outpatients with schizophrenia.
Nineteen outpatients with schizophrenia were divided into experimental (EG) (n=8; mean age 39±7 years) and control (CG) (n=11; mean age 40±6 years) groups. The EG underwent twice a week sessions of a group PA program for a period of 16-weeks. The participants completed a battery of tests at baseline and after 16-weeks, which included the assessment of body composition (dual-energy X-ray absorptiometry), functional exercise capacity (6MWT), physical activity levels (accelerometers), quality of life (WHOQOL-Brief), and anthropometric measures. During the program different strategies were implemented to ensure the participants’ adherence.
The attendance to the program was 79.7%. In the EG a significant decrease was observed in hip circumference (p = 0.02); a significant increase occurred in moderate to vigorous physical activity (p = 0.05) and in the environment domain (WHOQOL-Brief) (p = 0.02). The improvement in environment domain scores was also associated with a decrease in sedentary behavior (r = -0.82, p = 0.01) in the EG.
The strategies used during the program promoted a high rate of attendance. PA may have a positive impact on the participants’ ability to perform activities of daily living. This study showed that a group PA program can be successfully implemented for outpatients with schizophrenia and can influence their quality of life and PA levels.
Available from: Laurent Boyer
- "In our study, we did not find a direct relationship between neurocognition and QoL. Previous studies on this subject were not consistent , as some have found positive (Addington et al., 2005; Galletly et al., 1997), negative (Kurtz and Tolman, 2011; Narvaez et al., 2008; Prouteau et al., 2005) or the absence of, relationships (Aksaray et al., 2002; Brissos et al., 2008; Heslegrave et al., 1997). The correlation between memory performances and insight seems to confirm a recent study that identified memory acquisition as the only significant predictor of knowledge outcome involved in insight (Jahn et al., 2011). "
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ABSTRACT: The aim of this study was to assess the impact of insight into illness on self-reported quality of life (QoL) for patients with schizophrenia.
This cross-sectional study was conducted in the psychiatric department of a French public university teaching hospital. The data collected included socio-demographic information, clinical characteristics, medications, cognitive performance assessments, insight into illness, and the S-QoL 18. A multivariate analysis using multiple linear regressions was performed to determine variables potentially associated with QoL levels.
One hundred and thirteen outpatients with stable schizophrenia were enrolled in our study. Significant associations were found between QoL and socio-demographic characteristics: a higher QoL was associated with marital status (in couple) and employment. Concerning insight into illness, lower QoL levels were associated with better awareness of the mental disorder, whereas higher QoL levels were associated with better awareness of positive and negative symptoms. Elementary neuropsychological measures were not statistically associated with QoL.
Insight into illness, marital status and employment were the most important features associated with QoL, whereas there was no evidence that elementary neurocognition directly influenced QoL. The different facets of insight into illness should be considered to guide the development of specific interventions intended to improve QoL. Moreover, this study highlights the need for clinicians to pay more attention to the personal impact of schizophrenia, especially upon family life and work.
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