title: Functional outcomes in schizophrenia: understanding the competence-performance discrepancy.
abstract: A problem in the study and treatment of functional disability in schizophrenia is that factors other than competence (what one can do) can limit real-world performance (what one does). We examined predictors of the competence-performance discrepancy in both adaptive and interpersonal domains. Patients with schizophrenia (N = 96) were evaluated at baseline of a clinical treatment study. Discrepancy scores were created by considering each subject's competence relative to their real-world performance in interpersonal and adaptive behaviour domains. Logistic regression analyses revealed that for the interpersonal competence-performance discrepancy, living in a group home, better neurocognition, more time spent in the hospital since a first episode of psychosis, and a longer first hospitalization predicted a greater discrepancy between interpersonal competence and performance measures. For adaptive behaviour, shorter time since most recent hospitalization, more depressive symptoms, greater number of months of first hospitalization, older age at baseline, younger age at first hospitalization, and more time spent in the hospital since a first episode of psychosis predicted a greater adaptive competence-performance discrepancy. A different pattern of demographic and clinical features may limit the extent to which patients are deploying interpersonal versus adaptive skills in everyday life.
authors.affiliation: Department of Psychology, Queen's University, 62 Arch Street, Kingston, ON K7L 3N6, Canada.
authors.forename: Maya
authors.initials: M
authors.lastname: Gupta
authors.forename: Emma
authors.initials: E
authors.lastname: Bassett
authors.forename: Felicia
authors.initials: F
authors.lastname: Iftene
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Bowie
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015928:Cognitive Behavioral Therapy; D032882:Comprehension; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications* / Q000534:rehabilitation; D012565:Schizophrenic Psychology