title: Functioning in early and late stages of schizophrenia.
abstract: BACKGROUND
  Schizophrenia is frequently associated with a debilitating course and prominent impairment in social and occupational functioning. Although the criteria for classification into stages have not been defined in the literature, illness duration and functioning seem to be good candidates.
  
  
  OBJECTIVE
  To compare functioning of patients with schizophrenia at different stages of the disease (early vs. late) and healthy sex- and age-matched controls.
  
  
  METHODS
  This double-blinded, case-controlled study included 79 individuals: 23 patients with schizophrenia diagnosed up to 5 years earlier; 19 patients with schizophrenia diagnosed at least 20 years earlier; and healthy matched controls. Diagnoses were established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) Axis I Disorder. Functioning was assessed using the Functioning Assessment Short Test (FAST).
  
  
  RESULTS
  Patients in the early stage had significantly higher scores than healthy controls in total FAST and in autonomy, occupational functioning, cognitive functioning and interpersonal relationships. Individuals in the late stage had significantly poorer functioning than controls in all domains. The comparison of functioning between the two groups of patients revealed no significant differences, except in occupational functioning, in which late stage patients had a poorer performance.
  
  
  CONCLUSIONS
  Functioning impairment in schizophrenia tends to remain stable despite illness duration. Therefore, functioning should be effectively assessed at an early stage, as illness duration alone may not be the most reliable criterion to stage patients with schizophrenia.
authors.affiliation: Interdisciplinary Laboratory of Clinical Neuroscience, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Leonardo Gazzi
authors.initials: LG
authors.lastname: Costa
authors.affiliation: Laboratory of Molecular Psychiatry, INCT-TM, HCPA, Graduate Program in Medicine: Psychiatry, UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Raffael
authors.initials: R
authors.lastname: Massuda
authors.affiliation: Laboratory of Molecular Psychiatry, INCT-TM, HCPA, Graduate Program in Medicine: Psychiatry, UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Mariana
authors.initials: M
authors.lastname: Pedrini
authors.affiliation: Laboratory of Molecular Psychiatry, INCT-TM, HCPA, Graduate Program in Medicine: Psychiatry, UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Ives Cavalcante
authors.initials: IC
authors.lastname: Passos
authors.affiliation: Laboratory of Molecular Psychiatry, INCT-TM, HCPA, Graduate Program in Medicine: Psychiatry, UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Leticia Sanguinetti
authors.initials: LS
authors.lastname: Czepielewski
authors.affiliation: LINC, Department of Psychiatry, UNIFESP, São Paulo, SP, Brazil.
authors.forename: Elisa
authors.initials: E
authors.lastname: Brietzke
authors.affiliation: Laboratory of Molecular Psychiatry, INCT-TM, HCPA, Graduate Program in Medicine: Psychiatry, UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Clarissa S
authors.initials: CS
authors.lastname: Gama