title: Psychiatric symptoms mediate the effects of neurological soft signs on functional outcomes in patients with chronic schizophrenia: A longitudinal path-analytic study.
abstract: Neurological soft signs (NSS) in motor coordination and sequencing occur in schizophrenia patients and are an intrinsic sign of the underlying neural dysfunctions. The present longitudinal study explored the relationships among NSS, psychiatric symptoms, and functional outcomes in 151 Chinese patients with chronic schizophrenia across a 6-month period. The participants completed neurological assessments at baseline (Time 1), psychiatric interviews at Time 1 and 3-month follow-up (Time 2), and self-report measures on daily functioning at 6-month follow-up (Time 3). Two possible (combined and cascading) path models were examined on predicting the functional outcomes. Direct and indirect effects of Time 1 NSS on Time 3 functional outcomes via Time 2 psychiatric symptoms were evaluated using path analysis under bootstrapping. Motor coordination and sequencing NSS did not have significant direct effects on functional outcomes. Motor coordination NSS exerted significant and negative indirect effects on functional outcomes via psychiatric symptoms. These results contribute to a better understanding of the determinants of functional outcomes by showing significant indirect pathways from motor coordination NSS to functional outcomes via psychiatric symptoms. That motor sequencing NSS did not affect functional outcomes either directly or indirectly may be explained by their trait marking features.
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Dept of Social Work & Social Administration, The University of Hong Kong, Hong Kong.
authors.forename: Ted C T
authors.initials: TC
authors.lastname: Fong
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Dept of Social Work & Social Administration, The University of Hong Kong, Hong Kong. Electronic address: tinho@hku.hk.
authors.forename: Rainbow T H
authors.initials: RT
authors.lastname: Ho
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Dept of Social Work & Social Administration, The University of Hong Kong, Hong Kong.
authors.forename: Adrian H Y
authors.initials: AH
authors.lastname: Wan
authors.affiliation: The Providence Garden for Rehab, Hong Kong Sheng Kung Hui Welfare Council Limited, Hong Kong.
authors.forename: Friendly S W
authors.initials: FS
authors.lastname: Au-Yeung
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009460:Neurologic Examination; D010641:Phenotype; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology
keywords: Daily functioning; Disorganized symptoms; Mediation; Negative symptoms; Neurological deficits; Path analysis