Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-17T11:25:36.146Z Has data issue: false hasContentIssue false

Activities of daily living, social functioning and their determinants in persons with psychotic disorder

Published online by Cambridge University Press:  15 April 2020

S. Viertiö*
Affiliation:
National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271Helsinki, Finland
A. Tuulio-Henriksson
Affiliation:
National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271Helsinki, Finland Social Insurance Institution, Research DepartmentPO Box 450, 00101Helsinki, Finland
J. Perälä
Affiliation:
National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271Helsinki, Finland
S.I. Saarni
Affiliation:
National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271Helsinki, Finland
S. Koskinen
Affiliation:
National Institute for Health and Welfare, Welfare and Health Policies, PO Box 30, 00271Helsinki, Finland
M. Sihvonen
Affiliation:
Department of General Practice and Primary Health Care, Institute of Clinical Medicine, PO Box 20, 00014 University of Helsinki, Helsinki, Finland
J. Lönnqvist
Affiliation:
National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271Helsinki, Finland
J. Suvisaari
Affiliation:
National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271Helsinki, Finland
*
*Corresponding author. Tel.: +358 20 610 8784; fax: +358 20 610 7191. E-mail address: [email protected]
Get access

Abstract

Objective

The determinants of everyday functioning in persons with psychotic disorder have not been widely studied in community dwelling samples. Our aim was to investigate limitations in everyday functioning among subjects with psychotic disorders in a population-based study.

Method

Everyday functioning was assessed in a nationally representative sample of 7112 persons aged 30+ using interviewer observations and self-reports, while verbal fluency and memory were also measured. Diagnostic assessment of DSM-IV psychotic disorders was based on SCID interview and case-note data. Lifetime-ever diagnoses of psychotic disorder were classified into schizophrenia (n = 61), other non-affective psychotic disorders (ONAP) (n = 79) and affective psychoses (n = 45).

Result

Non-affective psychotic disorder was significantly associated with limitations in everyday functioning, as well as with deficits in verbal fluency and memory. Negative symptoms, depression, age, gender, verbal memory deficits, and reduced visual acuity were predictors of limitations in everyday functioning even after controlling for sociodemographic factors and chronic medical conditions, and difficulties in social functioning were also related to expressive speech problems.

Conclusion

Persons with schizophrenia and ONAP have significantly more problems in everyday functioning than the general population. One significant predictor of problems was reduced visual acuity, which at least in some situations could be easily corrected.

Type
Original articles
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N.The scale for the assessment of positive symptoms (SAPS). Iowa City: The University of Iowa; 1984.Google Scholar
Andreasen, N.C.Negative symptoms in schizophrenia. Definition and reliability. Arch Gen Psychiatry. 1982; 39: 784788.CrossRefGoogle ScholarPubMed
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J.An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4: 561571.CrossRefGoogle ScholarPubMed
Bowie, C.R., Reichenberg, A., Patterson, T.L., Heaton, R.K., Harvey, P.D.Determinants of real-world functional performance in schizophrenia subjects: correlations with cognition, functional capacity, and symptoms. Am J Psychiatry. 2006; 163: 418425.CrossRefGoogle ScholarPubMed
Bowie, C.R., Twamley, E.W., Anderson, H., Halpern, B., Patterson, T.L., Harvey, P.D.Self-assessment of functional status in schizophrenia. J Psychiatr Res. 2007; 41: 10121018.CrossRefGoogle Scholar
Chopra, P.K., Couper, J.W., Herrman, H.The assessment of patients with long-term psychotic disorders: application of the WHO Disability Assessment Schedule II. Aust N Z J Psychiatry. 2004; 38: 753759.CrossRefGoogle ScholarPubMed
DeSisto, M.J., Harding, C.M., McCormick, R.V., Ashikaga, T., Brooks, G.W.The Maine and Vermont three-decade studies of serious mental illness. I. Matched comparison of cross-sectional outcome. Br J Psychiatry. 1995; 167: 331338.CrossRefGoogle ScholarPubMed
Green, M.F.What are the functional consequences of neurocognitive deficits in schizophrenia?. Am J Psychiatry. 1996; 153: 321330.Google Scholar
Harvey, P.D., Howanitz, E., Parrella, M., White, L., Davidson, M., Mohs, R.C.et al.Symptoms, cognitive functioning, and adaptive skills in geriatric patients with lifelong schizophrenia: a comparison across treatment sites. Am J Psychiatry. 1998; 155: 10801086.CrossRefGoogle ScholarPubMed
Harvey, P.D., Koren, D., Reichenberg, A., Bowie, C.R.Negative symptoms and cognitive deficits: what is the nature of their relationship?. Schizophr Bull. 2006; 32: 250258.CrossRefGoogle ScholarPubMed
Harvey, P.D., Velligan, D.I., Bellack, A.S.Performance-based measures of functional skills: usefulness in clinical treatment studies. Schizophr Bull. 2007; 33: 11381148.CrossRefGoogle ScholarPubMed
Heistaro, S.Methodology report. Health 2000 Survey. Helsinki: Publications of the National Public Health Institute KTL/B 26; 2008.Google Scholar
Jin, H., Zisook, S., Palmer, B.W., Patterson, T.L., Heaton, R.K., Jeste, D.V.Association of depressive symptoms with worse functioning in schizophrenia: a study in older outpatients. J Clin Psychiatry. 2001; 62: 797803.CrossRefGoogle ScholarPubMed
Kattainen, A., Salomaa, V., Härkänen, T., Jula, A., Kaaja, R., Kesäniemi, Y.A.et al.Coronary heart disease: from a disease of middle-aged men in the late 1970s to a disease of elderly women in the 2000s. Eur Heart J. 2006; 27: 296301.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A.B., Moskowitz, R.W., Jackson, B.A., Jaffe, M.W.Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA. 1963; 185: 914919.CrossRefGoogle ScholarPubMed
Kendler, K.S., Karkowski-Shuman, L., O’Neill, F.A., Straub, R.E., MacLean, C.J., Walsh, D.Resemblance of psychotic symptoms and syndromes in affected sibling pairs from the Irish Study of High-Density Schizophrenia Families: evidence for possible etiologic heterogeneity. Am J Psychiatry. 1997; 154: 191198.Google ScholarPubMed
Klapow, J.C., Evans, J., Patterson, T.L., Heaton, R.K., Koch, W.L., Jeste, D.V.Direct assessment of functional status in older patients with schizophrenia. Am J Psychiatry. 1997; 154: 10221024.Google ScholarPubMed
Kurz, X., Scuvee-Moreau, J., Rive, B., Dresse, A.A new approach to the qualitative evaluation of functional disability in dementia. Int J Geriatr Psychiatry. 2003; 18: 10501055.CrossRefGoogle ScholarPubMed
Laes, J.R., Sponheim, S.R.Does cognition predict community function only in schizophrenia? A study of schizophrenia patients, bipolar affective disorder patients, and community control subjects. Schizophr Res. 2006; 84: 121131.CrossRefGoogle ScholarPubMed
Laitinen, A., Sainio, P., Koskinen, S., Rudanko, S.L., Laatikainen, L., Aromaa, A.The association between visual acuity and functional limitations: findings from a nationally representative population survey. Ophthalmic Epidemiol. 2007; 14: 333342.CrossRefGoogle ScholarPubMed
Lawton, M.P., Brody, E.M.Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9: 179186.CrossRefGoogle ScholarPubMed
Leary, J., Johnstone, E.C., Owens, D.G.Social outcome. Br J Psychiatry Suppl. 13–20 1991 4446.Google Scholar
McWhinnie, J.R.Disability assessment in population surveys: results of the O.E.C.D. Common Development Effort. Rev Epidemiol Sante Publique. 1981; 29: 413419.Google ScholarPubMed
Morris, J.C., Heyman, A., Mohs, R.C., Hughes, J.P., van Belle, G., Fillenbaum, G.et al.The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology. 1989; 39: 11591165.Google Scholar
Patterson, T.L., Klapow, J.C., Eastham, J.H., Heaton, R.K., Evans, J.D., Koch, W.L.et al.Correlates of functional status in older patients with schizophrenia. Psychiatry Res. 1998; 80: 4152.CrossRefGoogle ScholarPubMed
Perälä, J., Suvisaari, J., Saarni, S.I., Kuoppasalmi, K., Isometsä, E., Pirkola, S.et al.Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007; 64: 1928.CrossRefGoogle Scholar
R. Development Core Team R: A language and environment for statistical computing. 2. 6. 1 ed.Vienna, Austria: R Foundation for Statistical Computing; 2008.Google Scholar
Research Triangle Institute, SUDAAN Language Manual Release 9. 0. Research Triangle Park, NC: Research Triangle Institute; 2004.Google Scholar
Saarni, S.E., Saarni, S.I., Fogelholm, M., Heliövaara, M., Perälä, J., Suvisaari, J.et al.Body composition in psychotic disorders: a general population survey. Psychol Med. 2008 110.Google ScholarPubMed
Sainio, P., Koskinen, S., Heliövaara, M., Martelin, T., Härkänen, T., Hurri, H.et al.Self-reported and test-based mobility limitations in a representative sample of Finns aged 30+. Scand J Public Health. 2006; 34: 378386.CrossRefGoogle Scholar
Sciolla, A., Patterson, T.L., Wetherell, J.L., McAdams, L.A., Jeste, D.V.Functioning and well-being of middle-aged and older patients with schizophrenia: measurement with the 36-item short-form (SF-36) health survey. Am J Geriatr Psychiatry. 2003; 11: 629637.Google ScholarPubMed
Siegel, S.J., Irani, F., Brensinger, C.M., Kohler, C.G., Bilker, W.B., Ragland, J.D.et al.Prognostic variables at intake and long-term level of function in schizophrenia. Am J Psychiatry. 2006; 163: 433441.CrossRefGoogle Scholar
Simon, G.E., Bauer, M.S., Ludman, E.J., Operskalski, B.H., Unutzer, J.Mood symptoms, functional impairment, and disability in people with bipolar disorder: specific effects of mania and depression. J Clin Psychiatry. 2007; 68: 12371245.CrossRefGoogle ScholarPubMed
Suvisaari, J., Perälä, J., Saarni, S.I., Härkänen, T., Pirkola, S., Joukamaa, M.et al.Type 2 diabetes among persons with schizophrenia and other psychotic disorders in a general population survey. Eur Arch Psychiatry Clin Neurosci. 2008; 258: 129136.CrossRefGoogle Scholar
Viertiö, S., Laitinen, A., Perälä, J., Saarni, S.I., Koskinen, S., Lönnqvist, J.et al.Visual impairment in persons with psychotic disorder. Soc Psychiatry Psychiatr Epidemiol. 2007; 42: 902908.CrossRefGoogle ScholarPubMed
Viertiö, S., Sainio, P., Koskinen, S., Perälä, J., Saarni, S.I., Sihvonen, M.et al.Mobility limitations in persons with psychotic disorder: findings from a population-based survey. Soc Psychiatry Psychiatr Epidemiol. 2009; 44: 325332.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.