Disorganisation and cognition (particularly verbal memory) each influence quality of life (QoL) in people with schizophrenia and are promising targets of interventions to improve functional outcomes, say researchers.
The research team led by Paola Rocca (University of Turin, Italy) undertook a cross-sectional study involving 276 consecutive patients with stable schizophrenia attending an outpatient clinic.
All patients underwent neuropsychological tests to evaluate their attentive functions, verbal memory and executive functions. Psychiatric assessments were also performed to measure symptom severity and QoL.
Writing in Schizophrenia Research, Rocca et al report that the patients’ mean age was 40 years, the mean disease duration of was 14.2 years, and 42% were women. In general, symptom severity was moderate while QoL was significantly impaired.
In univariate analysis, two variables of interest – disorganisation (ie, “disorganised” subtype of schizophrenia) and verbal memory (assessed as the number of items correctly recalled over five learning trials of the California Verbal Learning Test) – were significantly negatively associated with patients’ QoL (assessed using the Heinrichs–Carpenter QoL Score, QLS).
Further analysis showed that disorganisation inversely correlated with total QLS and with two individual QLS domains: role-functioning (eg, occupational/educational) and intrapsychic functioning (eg, motivation, curiosity, and empathy).
Interestingly, verbal memory was a partial mediator of the relationship between disorganisation and QoL. Thus, there was a strong direct relationship between disorganisation and QoL as well as a weaker indirect relationship.
“These results highlight the importance of improving disorganization and cognition (particularly verbal memory) to improve the functional outcomes of patients with schizophrenia,” write Rocca and fellow authors.
Noting that currently available antipsychotic drugs are more effective for treating delusions and hallucinations than conceptual disorganisation or cognitive impairments, the researchers remark: “A variety of psychological and social interventions are needed to optimize recovery and should constitute an essential part of schizophrenia treatment.”
They add: “We can conclude that greater attention must be given to the systematic investigation and treatment of these symptoms, as the QOL in stable schizophrenia may be improved by interventions targeting disorganization and verbal memory.”
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