title: Negative symptoms and everyday functioning in schizophrenia: a cross-sectional study in a real world-setting.
abstract: Negative symptoms have been suggested to have a greater impact on real-world functioning in schizophrenia than other symptoms. We aimed to examine the relationship of specific negative symptoms components ("expressive deficits" - DE - which include alogia and blunted affect, and "avolition" - AA - which includes amotivation, anhedonia, and asociality), with separate domains of real-world outcomes (the Personal and Social Performance Scale - PSP - and selected items of the Heinrichs Quality of Life Scale - QLS - that did not overlap with negative symptoms) and two functional milestones (recent employment and marriage). Regression analyses were performed to identify the determinants of QLS and PSP scores and of the two milestones, in 92 consecutive outpatients with stable schizophrenia. AA was the strongest predictor of QLS interpersonal relations and social network (IRSN), PSP total score and the first three PSP domains. The variance explained ranged from 36% for PSP self care to 54% for the PSP personal and social relationships. Moreover, higher scores in AA were significant predictors of the single status. DE does not appear to have an impact at real-world functional performance. Taken together, our analysis indicates a relatively specific set of relationships between the AA subdomain and aspects of real-world functioning in schizophrenia. These findings, if confirmed, could have important implications for research, diagnostics and treatment: in fact our results would suggest that AA and DE should be analyzed as separate and distinct domains to be rated and treated individually.
authors.affiliation: Department of Neuroscience, Psychiatric Section, University of Turin, SSCVD, Via Cherasco 11, 10126 Turin, Italy; Department of Mental Health ASL TO1, via San Secondo 29, 10128 Turin, Italy. Electronic address: paola.rocca@unito.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Rocca
authors.affiliation: Department of Neuroscience, Psychiatric Section, University of Turin, SSCVD, Via Cherasco 11, 10126 Turin, Italy; Department of Mental Health ASL TO1, via San Secondo 29, 10128 Turin, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Montemagni
authors.affiliation: Department of Neuroscience, Psychiatric Section, University of Turin, SSCVD, Via Cherasco 11, 10126 Turin, Italy; Department of Mental Health ASL TO1, via San Secondo 29, 10128 Turin, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Zappia
authors.affiliation: Department of Mental Health ASL TO1, via San Secondo 29, 10128 Turin, Italy.
authors.forename: Rosellina
authors.initials: R
authors.lastname: Piterà
authors.affiliation: Department of Neuroscience, Psychiatric Section, University of Turin, SSCVD, Via Cherasco 11, 10126 Turin, Italy; Department of Mental Health ASL TO1, via San Secondo 29, 10128 Turin, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Sigaudo
authors.affiliation: Department of Neuroscience, Psychiatric Section, University of Turin, SSCVD, Via Cherasco 11, 10126 Turin, Italy; Department of Mental Health ASL TO1, via San Secondo 29, 10128 Turin, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Bogetto
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D003072:Cognition Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012559:Schizophrenia / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012648:Self Care / Q000523:psychology; D012919:Social Behavior; D055815:Young Adult
keywords: Avolition; Expressive deficits; Functional milestones; Real-world functioning