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Multivariate predictors of social skills performance in middle-aged and older out-patients with schizophrenia spectrum disorders

Published online by Cambridge University Press:  06 September 2007

D. I. Sitzer ,
E. W. Twamley ,
T. L. Patterson  and
D. V. Jeste
D. I. Sitzer
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA
E. W. Twamley*
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA
T. L. Patterson
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA Division of Geriatric Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
D. V. Jeste
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA Division of Geriatric Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
*
*Address for correspondence: E. W. Twamley, Ph.D., Assistant Professor of Psychiatry, University of California, San Diego, 140 Arbor Drive, San Diego, CA 92103, USA. (Email: [email protected])
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Abstract

Background

Cognitive impairment and negative symptoms are two of the primary features of schizophrenia associated with poor social functioning. We examined the relationships between clinical characteristics, specific cognitive abilities and social skills performance in middle-aged and older out-patients with schizophrenia and normal comparison subjects.

Method

One hundred and ninety-four middle-aged and older schizophrenia out-patients and 60 normal comparison subjects were administered a standardized, performance-based measure of social skills using role-plays of various social situations [Social Skills Performance Assessment (SSPA)] and measures of current level of social contact (the Lehman Quality of Life Interview), psychiatric symptom severity [the Positive and Negative Syndrome Scale (PANSS) and the Hamilton Depression Rating Scale (HAMD)], insight [the Birchwood Insight Scale (IS)] and cognitive functioning [the Mattis Dementia Rating Scale (DRS)].

Results

Patients demonstrated worse social skills compared with normal subjects. Better performance on the SSPA was associated with having less severe positive and negative symptoms, fewer social contacts, and better attention, initiation/freedom from perseveration, visuospatial ability, abstraction ability and memory. After controlling for demographic, clinical and insight-related factors, abstraction ability was the strongest predictor of social skills performance, followed by frequency of social contact.

Conclusions

Social functioning (as measured through direct observation of social skills performance) was related to cognitive ability in out-patients with schizophrenia. Addressing such cognitive impairment may help to improve social functioning and result in greater overall quality of life.

Keywords

Cognitionmemorypsychotic disorderssocial support
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 755 - 763
Copyright
Copyright © Cambridge University Press 2007

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