Abstract
Schizophrenia is characterized by three general categories of impairment: (1) positive symptoms (2) negative symptoms and (3) cognitive deficits. In addition, adaptive functioning – an individual's ability to perform basic activities of daily living (ADL's) such as grooming, cooking, and cleaning--is often severely compromised in patients with this illness. While recent studies have addressed the relationships between symptomatology and cognitive dysfunction in schizophrenia, studies which have examined these variables in relation to adaptive functioning have tended to focus on global indices of functional ability, such as social and occupational functioning. There is little information regarding the relationship between symptomatology, cognitive impairment and adaptive functioning in terms of specific ADL's. Ability to perform ADL's is an important treatment outcome variable which has often been overlooked. For the present study, subjects were 110 patients meeting DSM III-R criteria for schizophrenia or schizoaffective disorder who were recently hospitalized for an acute exacerbation of illness. Measures of positive symptoms (Brief Psychiatric Rating Scale), negative symptoms (Negative Symptom Assessment (NSA)), and adaptive functioning (Functional Needs Assessment (FNA)) were obtained following 2 weeks of treatment with standard antipsychotic medications. Multiple regression analyses were used to examine the relative utility of positive versus negative symptomatology in predicting concurrent adaptive functioning. Results revealed that negative symptoms (global NSA score) predicted almost 30% of the variance in FNA scores. Positive symptoms did not explain additional variance. When the 6 factors composing the NSA were utilized as independent variables predicting to FNA scores, results revealed that the “cognition” factor was the only factor predicting functional ability, accounting for 46% of the variance in FNA scores. As new drug treatments are developed which allow more patients to be discharged, it will be increasingly important to be able to predict functioning outside the hospital. The NSA “cognition” factor may be a simple, cost effective way to do this. In addition, treatments which help compensate for the cognitive deficits underlying functional impairments should be pursued.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Velligan, D., True, J., Lefton, R. et al. The Functional Significance Of Symptomatology And Cognitive Dysfunction In Schizophrenia. Neuropsychopharmacol 11, 288 (1994). https://doi.org/10.1038/sj.npp.1380226
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.npp.1380226