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Disability in schizophrenia. Intrinsic factors and prediction of psychosocial outcome. An analysis of literature

Published online by Cambridge University Press:  07 August 2014

Bernardo Carpiniello  and
Mauro G. Carta
Bernardo Carpiniello*
Affiliation:
Dipartimento di Sanità Pubblica, Sezione di Psichiatria, Università degli Studi di Cagliari, Cagliari
Mauro G. Carta
Affiliation:
Dipartimento di Sanità Pubblica, Sezione di Psichiatria, Università degli Studi di Cagliari, Cagliari
*
Indirizzo per la corrispondenza: Professor B. Carpiniello, Dipartimento Sanità Pubblica, Sezione di Psichiatria, Via Liguria 13, 09127 Cagliari. Fax:+39-070-496.295
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Summary

Objective – Many different factors, both related to the individual and illness (“intrinsic” factors) and to the environment (“extrinsic” factors), contribute in different ways to the development of disability. Basing on data of literature, this review focuses the main “intrinsic” factors predicting disability in schizophrenia. Method – A systematic search on Mediline of all papers published during the period 1965-2001 was performed, using “schizophrenia”, “outcome”, “psychosocial outcome”, “social disability” and “social adjustment” as key words. Only papers reporting specifically data about predictive factors and psychosocial outcome variables were considered; prospective follow-up studies were considered, but retrospective and cross-sectional studies were also taken into account when data deriving from prospective studies were inconsistent. Results – Male sex predicts a higher disability among demographic factors; lower social and occupational adjustment are premorbid personality factors associated with higher disability; among factors related to illness, younger age at onset of illess, “nuclear”, “non paranoid” and in particular “deficit” forms of schizophrenia seem to predict more disability. The latter seems to be predicted also by higher levels of negative symptoms and neuropsychological deficits ; the role of depressive symptoms seems to be less supported by follow-up data; a continuous course of the illness predicts more disability, although some evidences show a progressive reduction of disability, at least in the long term. Conclusions – Disability shows a largely autonomous course respect to symptoms and has to be considered an independent parameter of outcome. Few intrinsic factors show a predictive role also in the long term.

Keywords

social disabilityschizophreniarisk factorspredictionpsychosocial outcomedisabilità socialeschizofreniaesito psicosocialefattori predittivifattori di rischio
Type
Papers
Information
Epidemiology and Psychiatric Sciences , Volume 11 , Issue 1 , March 2002 , pp. 45 - 58
Copyright
Copyright © Cambridge University Press 2002

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References

BIBLIOGRAFIA

Affleck, J.W., Burns, J. & Forrest, A.D. (1976). Long term follow-up of schizophrenic patients in Edinburgh. Acta Psychiatrica Scandinavica 53, 227–237.CrossRefGoogle ScholarPubMed
Bailer, J., Brauer, W. & Rey, E.R. (1996). Premorbid adjustment as predictor of outome in schizophreniarresults of a prospective study. Acta Psychiatrica Scandinavica 93, 368–377.CrossRefGoogle Scholar
Beiser, M., Bean, G., Erickson, D., Zhang, J., Jacono, W.G. & Rector, N.A. (1994). Biological and psychological predictors of job performance following a first episode of psychosis. American Journal of Psychiatry 151, 857–863.Google Scholar
Bell, M.D. & Bryson, G. (2001). Work rehabilitation in schizophrenia: does cognitive impairment limit improvement? Schizophrenia Bulletin 27, 269–279.CrossRefGoogle ScholarPubMed
Bellack, A.S., Morrison, R.L., Wixted, J.T. & Mueser, K.T. (1990). An analysis of social competence in schizophrenia. British Journal of Psychiatry 156, 809–818.CrossRefGoogle ScholarPubMed
Betti, S., Scarlato, A. & Resele, L.F. (1990). Relazione tra diagnosi ed aree specifiche di disabilità: valutazione di alcune variabili cliniche, sociali e familiari. Rivista Sperimentale di Freniatria 115, 993–1005.Google Scholar
Bland, R.C. & Orn, H. (1978). 14-year outcome in early schizophrenia. Acta Psychiatrica Scandinavica 58, 327–338.CrossRefGoogle ScholarPubMed
Braff, D.L. (1993). Information processing and attention dysfunction in schizophrenia. Schizophrenia Bulletin 19, 233–259.CrossRefGoogle ScholarPubMed
Breier, A., Schreiber, J.L., Dyer, J. & Piekar, D. (1992). Course of illness and predictors of outcome in chronic schizophrenia: implication for pathophisiology. British Journal of Psychiatry 161, Suppl 18, 38–43.CrossRefGoogle Scholar
Brenner, H.D., Hodel, B., Roder, V. & Corrigan, P. (1992). Treatment of cognitive dysfunctions and behavioural deficits in schizophrenia: Integrated Psychological Therapy. Schizophrenia Bulletin 18, 21–26.CrossRefGoogle Scholar
Carpiniello, B., Salis, P., Pariante, C.M., Carta, M.G. & Rudas, N. (1995). Decorso clinico e disabilità sociale nella schizofrenia Risultati di uno studio catamnestico. Minerva Psichiatrica 36, 1–10.Google Scholar
Carpenter, W.T. jr & Strauss, J.S. (1991). The prediction of outcome in schizophrenia.IV: eleven-year follow-up of the Washington IPSS cohort. Journal of Nervous and Mental Diseases 179, 517–525.CrossRefGoogle ScholarPubMed
Ciompi, L. (1980). Catamnestic long-term study on the course of life and aging of schizophrenics. Schizophrenia Bulletin 6, 606–618.CrossRefGoogle ScholarPubMed
Coryell, W. & Tsuang, M.T. (1986). Outcome after 40 years in DSM-III Schizophreniform disorders. Archives of General Psychiatry 43, 324–328.CrossRefGoogle Scholar
Deister, A. & Marneros, A. (1994). Prognostic value of initial subtype in schizophrenic disorders. Schizophrenia Research 12, 145–147.CrossRefGoogle ScholarPubMed
De Jong, A., Giel, R., Sloof, G.L. & Wiersma, D. (1985). Social disability and outcome in schizophrenic patients. British Journal of Psychiatry, 147, 631–636.CrossRefGoogle ScholarPubMed
Done, D.J., Crow, T.J., Johnstone, E. & Sacker, A. (1994). Childhood an-tecededents of schizophrenia and affective illness. Social adjustment at age 7 and 11. British Medical Journal 309, 699–703.CrossRefGoogle ScholarPubMed
Eggers, C., Bunk, D., Volberg, G. & Ropcke, B. (1999). The ESSEN study of childhood-onset schizophrenia: sleeted results. European Child Adolescent Psychiatry 8, Suppl. 1, 121–128.CrossRefGoogle Scholar
Fenton, W.S. & McGlashan, T.H. (1986). The prognostic significance of obsessive-compulsive symptoms in schizophrenia. American Journal of Psychiatry 143, 437–441.Google ScholarPubMed
Fenton, W.S. & McGlashan, T.H. (1991a). Natural history of schizophrenia subtypes. I Longitudinal study of paranoid, hebephrenic and undifferentiated schizophrenia. Archives of General Psychiatry 48, 969–977.CrossRefGoogle ScholarPubMed
Fenton, W.S. & McGlashan, T.H. (1991b). Natural hystory of schizophrenia subtypes II. Positive and negative symptoms and long-term course. Archives of General Psychiatry 48, 978–986.CrossRefGoogle Scholar
Fenton, W.S. & McGlashan, T.H. (1994). Antecedents, symptom progression and long-term outcome of the deficit syndrome in schizophrenia. American Journal of Psychiatry 151, 351–351.Google ScholarPubMed
Ganev, K. (2000). Long-term trends of symptoms and disability in schizophrenia and related disorders. Social Psychiatry and Psychiatric Epidemiology 35, 389–395.CrossRefGoogle ScholarPubMed
Glazer, W., Aaronson, H.,.Prusoff, B. & Williams, D.H. (1980). Assessment of social adjiustment in chronic ambulatory schizophrenics. Journal of Nervous and Mental Disease 168, 493–497.CrossRefGoogle ScholarPubMed
Glazer, W., Prusoff, B., John, K. & Williams, D.H. (1981). Depression and social adjustment in chronic ambulatory schizophrenics. Journal of Nervous and Mental Disease 169, 712–717.CrossRefGoogle Scholar
Goldstein, M. & Kreisman, D. (1988). Gender, family environment and schizophrenia. Psychological Medicine 18, 861–872.CrossRefGoogle ScholarPubMed
Gross, G. & Huber, G. (1986). Classification and prognosis of schizophrenic disorders in light of the Bonn Follow-up studies. Psychopathology 19, 50–59.CrossRefGoogle ScholarPubMed
Grossman, L., Harrow, M., Goldberg, J.F. & Fitchner, C.G. (1991). Outcome of schizoaffective disorder at two long term follow-ups: comparison with outcome of schizophrenia and affective disorders. American Journal of Psychiatry 148, 1359–1365.Google ScholarPubMed
Gureje, O. & Bamidele, R. (1999). Thirteen-year social outcome among Nigerian outpatients with schizophrenia. Social Psychiatry and Psychiatric. Epidemiology 34, 147–151.CrossRefGoogle ScholarPubMed
Häfner, H. (2000). Onset and early course as determinants of the further course of schizophrenia. Acta Psychiatrica Scandinavica 102, Suppl. 407, 44–48.CrossRefGoogle Scholar
Häfner, H. & Nowotny, B. (1995). Epidemiology of early-onset schizophrenia. European Archives Psychiatry Clinical Neuroscience 245, 80–92.CrossRefGoogle ScholarPubMed
Häfner, H., Maurer, K., Loffler, W., an der Heiden, W., Munk-Jorgensen, P., Hambrecht, M. & Riecher-Rossler, A. (1998). The ABC Schizophrenia Study, a preliminary overview of results. Social Psychiatry and Psychiatric Epidemiology 33, 380–386.Google Scholar
Häfner, H., Loffler, W., Maurer, K., Hambrecht, M. & an der Heiden, W. (1999). Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatrica Scandinavica 100, 105–118.CrossRefGoogle ScholarPubMed
Harrison, G., Croudace, T., Mason, P., Glazebrook, C. & Medley, I. (1996). Predicting long-term outcome of schizophrenia. Psychological Medicine 26, 697–705.CrossRefGoogle ScholarPubMed
Harrow, M. & Marengo, J.T. (1986). Schizophrenic thought disorder at follow-up: its persistence and prognostic significance. Schizophrenia Bulletin 12, 373–393.CrossRefGoogle Scholar
Hauser, R. & Scharfetter, C. (1990). On the prognostic relevance of ego-psychopathology in schizophrenia: a 2.5-year follow- up. European Archives of Psychiatry and Neurological Sciences 239, 293–302.CrossRefGoogle Scholar
Ho, B.C., Nopoulos, P., Flaum, M., Arndt, S. & Andreasen, N. (1998). Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. American Journal of Psychiatry 155, 1196–1201.CrossRefGoogle ScholarPubMed
Huguelet, P., Zabala, I., Cruciani, G., Binyet, S., Favre, S., Gondales, C. & Ferrero, F. (1995). Four year follow-up of social adjiustment of a cohort of schizophrenic patients. Encephale 21, 93–98.Google ScholarPubMed
Jablensky, A., Sartorius, N., Ernberg, G., Anker, M., Korten, A., Cooper, J.E., Day, K. & Bertelsen, A. (1992). Schizophrenia: Manifestations, Incidence and Course in Different Cultures. A WHO Ten Country Study. Psychologogical Medicine, Monographical Supplement 20.Google ScholarPubMed
Johnstone, E.C., Frith, C.D., Crow, T.J., Owens, D.G., Done, D.J., Baldwin, E.J. & Charlette, A. (1992). The Northwick Park “Functional” Psychosis Study: diagnosis and outcome. Psychological Medicine 22, 331–343.CrossRefGoogle ScholarPubMed
Jonsson, S.A.T. & Jonsson, H. (1992). Outcome in untreated schizophrenia: a search for symptoms and traits with prognostic meanings in patients admitted to a mental hospital in the pre-neuro-leptic era. Acta Psychiatrica Scandinavica 85, 313–320.CrossRefGoogle ScholarPubMed
Jonsson, H. & Nyman, A.K. (1991). Predicting long-term outcome in schizophrenia. Acta Psychiatrica Scandinavica 83, 342–346.CrossRefGoogle ScholarPubMed
Keefe, R.S.E., Moos, R., Losonczy, M.F., Davidson, M., Silverman, J.F., Horman, T.B. & Davis, K.L. (1989). Premorbid sociosexual functioning and long-term outcome in schizophrenia. American Journal of Psychiatry 146, 206–211.Google ScholarPubMed
Lay, B., Blanz, B., Hartmann, M. & Schmidt, M.H. (2000). The psychosocial outcome of adolescent-onset schizophrenia: 10-12 year follow-up. Schizophrenia Bulletin 26, 801–816.CrossRefGoogle Scholar
Leff, J., Sartorius, N., Jablensky, A., Korten, A. & Enberg, G. (1992). The International Pilot Study of Schizophrenia: five-year follow-up findings. Psychological Medicine 22, 131–145.CrossRefGoogle ScholarPubMed
Lewis, S. (1992). Sex and schizophrenia: vive la difference. British Journal of Psychiatry 161, 45–450.CrossRefGoogle ScholarPubMed
Liddle, P.F. (2000). Cognitive impairment in schizophrenia: its impact on social functioning. Acta Psychiatrica Scandinavica, Suppl. 400, 11–16.Google Scholar
Lloyd, D., Simpson, J.C. & Tsuang, M. (1985). Are there sex differences in the long-term outcome of schizophrenia? Journal of Nervous and Mental Disease 173, 643–649.CrossRefGoogle Scholar
Loffler, W. & Häfner, H. (1999). Dimension of schizophrenic symptomatology. Comparative testing of several theoretical models in a first-episode population sample. Nervenartz 70, 416–429.Google Scholar
Marneros, A., Deister, A., Rohde, A., Steinmeyer, E.M. & Junemann, H. (1989a). Long-term outcome of schizoaffective and schizophrenic disorders.I. Definitions, methods, psychopathological and social outcome. European Archives Psychiatry Neurological Science 238, 118–125.CrossRefGoogle Scholar
Marneros, A., Steinmeyer, E.M., Deister, A., Rohde, A. & Junemann, H. (1989b). Long-term outcome of schizoaffective and schizophrenic disorders:a comparative study. III. Social consequences. European Archives Psychiatry Neurological Science 238, 135–139.CrossRefGoogle ScholarPubMed
Marneros, A., Deister, A. & Rodhe, A. (1990). Psychopathological and social status of patients with affective, schizophrenic and schizoaffective disorders after long-term course. Acta Psychiatrica Scandinavica 82, 352–358.CrossRefGoogle ScholarPubMed
McGlashan, T.H. (1986a). The prediction of outcome in chronic schizophrenia. IV.The Chestnut Lodge Follow up study. Archives of General Psychiatry 43, 167–176.CrossRefGoogle ScholarPubMed
McGlashan, T.H. (1986b). Predictors of shorter, medium and longer term outcome in schizophrenia. American Journal of Psychiatry 143, 50–55.Google ScholarPubMed
Menezes, P.R., Rodrigues, L.C. & Mann, A.H. (1997). Predictors of clinical and social outcomes after hospitalization in schizophrenia. European Archives Psychiatry Clinical Neurosciences 247, 137–145.CrossRefGoogle ScholarPubMed
Moller, H.J., Schimd-Bode, W., Cirding-Tommel, C., Wittchen, H.U., Zaudig, M. & von Zerssen, D. (1988). Psychopathological and social outcome in schizophrenia versus affective/schizoaffective psychoses and prediction of poor outcome in schizophrenia. Acta Psychiatrica Scandinavica 11, 379–389.CrossRefGoogle Scholar
Montero, I., Ruiz-Perez, I. & Gomez-Beneyto, M. (1998). Social adjustment in schizophrenia: factors predictive of short term social adjustment in a sample of schizophrenic patients. Acta Psychiatrica Scandinavica 97, 116–121.CrossRefGoogle Scholar
Munk-Jorgensen, P. & Mortesen, P.B. (1992). Social outcome in schizophrenia: a 13 year follow-up. Social Psychiatry and Psychiatric Epidemiology 27, 129–134.CrossRefGoogle ScholarPubMed
Nuechterlein, K.H. & Dawson, M.E. (1984). Information processing and attentional functioning in the development course of schizophrenic disorders. Schizophrenia Bulletin 10, 169–203.CrossRefGoogle Scholar
Ogawa, K., Miya, M., Watarai, A., Nakazawa, M., Yuasa, S. & Utena, H. (1987). A long-term follow-up study of schizophrenia in Japan with special reference to the course of social adjustment. British Journal of Psychiatry 151, 758–765.CrossRefGoogle Scholar
Ohman, A., Ohlund, L.S., Alm, T., Wieselgren, I.M., Ost, L.G. & Lindstrom, L.H. (1989). Electrodermal nonresponding, premorbid adjustment, and symptomatology as predictors of long-term social functioning in schizophrenics. Journal of Abnormal Psychology 98, 426–435.CrossRefGoogle ScholarPubMed
Opjordsmoen, S. (1991). Long-term clinical outcome of schizophrenia with special reference to gender differences. Acta Psychiatrica Scandinavica 83, 307–313.CrossRefGoogle ScholarPubMed
Patterson, T.L., Moscona, S., McKibbin, C.L., Davidson, K. & Jeste, D.V. (2001). Social skills performance assessment among older patients with schizophrenia. Schizophrenia Research 48, 351–360.CrossRefGoogle ScholarPubMed
Piccinelli, M. & Gomez Homen, F. (1997). Gender Differences in the Epidemiology of Affective Disorders and Schizophrenia. World Health Organization: Geneva.Google Scholar
Pope, A.M. & Tarlov, A.R. (1991). Disability in America. Toward a National Agenda for Prevention. Institute of Medicine, National Academy Press: Washington DC.Google Scholar
Prudo, R. & Blum, M. (1987). Five year outcome and prognosis in schizophrenia: a report from the London Field Research Center of the International Pilot Study of Schizophrenia. British Journal of Psychiatry 150, 345–354.CrossRefGoogle ScholarPubMed
Ring, N., Tantam, D., Montague, L., Newby, D., Black, D. & Morris, J. (1991). Gender differences in the incidence of definite schizophrenia and atypical psychosis. Focus on negative symptoms of schizophrenia. Acta Psychiatrica Scandinavica 84, 489–496.CrossRefGoogle ScholarPubMed
Salokangas, R.K.R. (1983). Prognostic implication of the sex of schizophrenic patients. British Journal of Psychiatry 142, 145–151.CrossRefGoogle ScholarPubMed
Salokangas, R.K.R. (1986). Psychosocial outcome in schizophrenia and psychotherapeutic orientation. Acta Psychiatrica Scandinavica 74, 497–506.CrossRefGoogle ScholarPubMed
Seeman, M.V. (1998). Narratives of twenty to thirty year outcomes in schizophrenia. Psychiatry 61, 249–261.CrossRefGoogle ScholarPubMed
Serban, G. (1979). Mental states, functioning and stress in chronic schizophrenics patients in community care. American Journal of Psychiatry 136, 948–951.Google Scholar
Serban, G. & Gydinsky, C.B. (1979). Relationship between cognitive deficit, affect response and community adjustment in chronic schizophrenics. British Journal of Psychiatry 134, 602–608.CrossRefGoogle Scholar
Shankar, R., Kamath, A.S. & Joseph, A. (1995). Gender differences in disability: a comparison of married patients with schizophrenia. Schizophrenia Research 16, 17–23.CrossRefGoogle ScholarPubMed
Shubart, C., Krumm, B., Biehl, H. & Schwarz, R. (1986). Measurement of social disability in a schizophrenic patient group. Social Psychiatry 21, 1–9.CrossRefGoogle Scholar
Schwarz, R. & Michael, J. (1977). Zum konzept (psychischer) Behinderung. Nervenartz 48, 656–662.Google Scholar
Strauss, J.S. & Carpenter, W.T. (1972). The prediction of outcome in schizophrenia. Archives of General Psychiatry 34, 37–42.Google Scholar
Strauss, J.S. & Carpenter, W.T. (1974). The prediction of outcome in schizophrenia. II. Relationships between predictor and outcome variables. Archives of General Psychiatry 31, 37–42.CrossRefGoogle ScholarPubMed
Tansella, M. (1997). Foreword. In Differences in the Epidemiology of Affective Disorders and Schizophrenia (Piccinelli, M. and Homen, F. Gomez), pp. V–XIV. World Health Organization: Geneva.Google Scholar
Test, M.A., Burke, S.S. & Wallish, L.S. (1990). Gender differences of young adults with schizophrenic disorders in community care. Schizophrenia Bulletin 16, 331–343.CrossRefGoogle ScholarPubMed
Thara, R. & Rajkumar, S. (1992). Gender differences in schizophrenia. Results of a follow-up study from India. Schizophrenia Research 7, 65–70.CrossRefGoogle ScholarPubMed
Tsoi, W.F. & Wong, K.E. (1991). A 15-year follow-up study of Chinese schizophrenic patients. Acta Psychiatrica Scandinavica 84, 217–220.CrossRefGoogle ScholarPubMed
Veltro, F. (1993). L'approccio psicosociale alia valutazione dell'esito delia schizofrenia. Epidemiologia e Psichiatria Sociale 2, 11–13.CrossRefGoogle Scholar
Watt, D.C., Katz, K. & Shepherd, M. (1983). The natural history of schizophrenia: a 5-year prospective follow-up of a representative sample of schizophrenics by means of standardized clinical and social assessment. Psychological Medicine 13, 663–670.CrossRefGoogle ScholarPubMed
Wiersma, D. (1996). Measuring social disabilities in mental health. Social Psychiatry and Psychiatric Epidemiology 31, 101–108.CrossRefGoogle ScholarPubMed
Wiersma, D., Nienhuis, F.J., Giel, R. & Slooff, C.J. (1998). Stability and change in needs of patients with schizophrenic disorders: a 15 and 17 year follow-up from first onset of psychosis, and a comparison between ‘objective’ and ‘subjective’ needs of care. Social Psychiatry and Psychiatric Epidemiology 33, 49–56.CrossRefGoogle Scholar
Wykes, T., Katz, R., Sturt, E. & Memsley, D. (1992). Response processing in a chronic psychiatric group. A possible predictor of rehabilitation failure. British Journal of Psychiatry 160, 244–252.CrossRefGoogle Scholar
World Health Organization (1979). Schizophrenia. An International Follow-up Study. John Wyley & Sons: Chichester.Google Scholar