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Current Psychiatry Research and Reviews


ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

Research Article

Cognition, Symptomatology, and Community Living Skills in Schizophrenia

Author(s): Wai Yee Sin, Wai Nga Wong, Yi To Michelle Lo, Uen Ting Elizabeth Tse, Hoi Wai Helen Wong, Ka Yin Elizabeth Tung, Amy Dun-mi Fung and Michael Chih Chien Kuo*

Volume 18, Issue 3, 2022

Published on: 30 August, 2022

Page: [220 - 228] Pages: 9

DOI: 10.2174/2666082218666220801095440

Price: $65


Background: Independence in community living is an important aspect of rehabilitation in schizophrenia. Previous studies investigating relationships of cognitive, symptomatic, and demographic factors in community living ability of schizophrenia showed inconsistent findings. These findings may be due to variations in functional measures used or a heterogenous sample of participants recruited.

Aim: To investigate the relationships of cognitive, symptomatic and demographic factors with community living skills for people with schizophrenia living in supported living facilities.

Methods: This is a cross-sectional study. Thirty-seven adults with schizophrenia and 32 matched healthy controls were recruited. Both groups completed the Verbal Fluency Test, subtests of Cognistat, and the Color Trail Test. Additional assessments (i.e., Chinese version of St. Louis Inventory of Community Living Skills – SLICLS-C and Positive and Negative Syndrome Scale – PANSS) were used to evaluate participants with schizophrenia. Cognitive profile was compared between the two groups. Correlation analysis was used to explore the relationships of cognitive abilities, symptomatology, and demographic factors with community living skills in schizophrenia.

Results: Results showed that participants with schizophrenia performed worse than the control group in verbal fluency, visual memory, immediate memory, delayed memory, and executive function tests. Significant moderate correlations between SLICLS-C score and participants’ years of education, positive symptoms, general psychopathology, and PANSS total score were identified.

Discussions and Conclusion: Results indicated that cognitive impairments are persistent in schizophrenia who are in remission and have been partially integrated back into the community. Cognitive deficits that people with schizophrenia experience might be stable over most of the course of the illness. Participants’ years of education, positive symptoms, general psychopathology, and PANSS total score might be important moderating variables to include in future investigations related to predicting community living performance in schizophrenia.

Keywords: Schizophrenia, cognition, symptom assessment, independent living, ADL, IADL.

Graphical Abstract
Kassebaum NJ, Arora M, Barber RM, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1603-58.
[] [PMID: 27733283]
Chong HY, Teoh SL, Wu DB-C, Kotirum S, Chiou C-F, Chaiyakunapruk N. Global economic burden of schizophrenia: A systematic review. Neuropsychiatr Dis Treat 2016; 12: 357-73.
[PMID: 26937191]
Schaefer J, Giangrande E, Weinberger DR, Dickinson D. The global cognitive impairment in schizophrenia: Consistent over decades and around the world. Schizophr Res 2013; 150(1): 42-50.
[] [PMID: 23911259]
Guo JY, Ragland JD, Carter CS. Memory and cognition in schizophrenia. Mol Psychiatry 2019; 24(5): 633-42.
[] [PMID: 30242229]
James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392(10159): 1789-858.
[] [PMID: 30496104]
Schultz SH, North SW, Shields CG. Schizophrenia: A review. Am Fam Physician 2007; 75(12): 1821-9.
[PMID: 17619525]
John A, Gandhi S, Prasad MK, Manjula M. Effectiveness of IADL interventions to improve functioning in persons with Schizophrenia: A systematic review. Int J Soc Psychiatry 2022; 68(3): 500-13. 00207640211060696.
[PMID: 34802260]
Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: Are we meas-uring the “right stuff”? Schizophr Bull 2000; 26(1): 119-36.
[] [PMID: 10755673]
Green MF, Kern RS, Heaton RK. Longitudinal studies of cognition and functional outcome in schizophrenia: Implica-tions for MATRICS. Schizophr Res 2004; 72(1): 41-51.
[] [PMID: 15531406]
Lipskaya L, Jarus T, Kotler M. Influence of cognition and symptoms of schizophrenia on IADL performance. Scand J Occup Ther 2011; 18(3): 180-7.
[] [PMID: 20560806]
Krishnadas R, Moore BP, Nayak A, Patel RR. Relationship of cognitive function in patients with schizophrenia in remis-sion to disability: A cross-sectional study in an Indian sample. Ann Gen Psychiatry 2007; 6(1): 19.
[] [PMID: 17663763]
Samuel R, Thomas E, Jacob KS. Instrumental activities of daily living dysfunction among people with schizophrenia. Indian J Psychol Med 2018; 40(2): 134-8.
[] [PMID: 29962569]
Bowie CR, Harvey PD. Cognitive deficits and functional outcome in schizophrenia. Neuropsychiatr Dis Treat 2006; 2(4): 531-6.
[] [PMID: 19412501]
Gjerdalen OS, Lystad JU, Bull H, Ringen PA, Røssberg JI, Martinsen EW. Vocational rehabilitation augmented with cognitive behavioral therapy or cognitive remediation for individuals with schizophrenia: A 5-year follow-up study. Nord J Psychiatry 2022; 1-8.
Green MF, Horan WP, Lee J. Nonsocial and social cognition in schizophrenia: Current evidence and future directions. World Psychiatry 2019; 18(2): 146-61.
[] [PMID: 31059632]
Sharma T, Antonova L. Cognitive function in schizophrenia. Deficits, functional consequences, and future treatment. Psychiatr Clin North Am 2003; 26(1): 25-40.
[] [PMID: 12683258]
Au RWC, Tam PWC, Tam GWC, Ungvari GS. Cross-cultural validation of the St. Louis Inventory of Community Liv-ing Skills for Chinese patients with schizophrenia in Hong Kong. Psychiatr Rehabil J 2005; 29(1): 34-40.
[] [PMID: 16075695]
Au RWC, Tam PWC, Tam GWC, Ungvari GS. Cross-cultural validation of the St. Louis inventory of community living skills for chinese patients with schizopheenia in Hong Kong. Psychiatr Rehabil J 2005; 29(1): 34-40.
Chiu HF, Chan CK, Lam LC, et al. The modified Fuld Verbal Fluency Test: A validation study in Hong Kong. J Gerontol B Psychol Sci Soc Sci 1997; 52(5): 247-50.
[] [PMID: 9310094]
Chan CCH, Lee TMC, Fong KNK, Lee C, Wong V. Cognitive profile for Chinese patients with stroke. Brain Inj 2002; 16(10): 873-84.
[] [PMID: 12419000]
Mitrushina M, Abara J, Blumenfeld A. Aspects of validity and reliability of the Neurobehavioral Cognitive Status Ex-amination (NCSE) in assessment of psychiatric patients. J Psychiatr Res 1994; 28(1): 85-95.
[] [PMID: 8064643]
Wallace JJ, Caroselli JS, Scheibel RS, High WM Jr. Predictive validity of the Neurobehavioural Cognitive Status Exami-nation (NCSE) in a post-acute rehabilitation setting. Brain Inj 2000; 14(1): 63-9.
[] [PMID: 10670662]
D’Elia L, Satz P, Uchiyama CL, White T. Color trails test professional manual. PAR Odessa FL 1996.
Dugbartey AT, Townes BD, Mahurin RK. Equivalence of the color trails test and trail making test in nonnative english-speakers. Arch Clin Neuropsychol 2000; 15(5): 425-31.
[] [PMID: 14590218]
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13(2): 261-76.
[] [PMID: 3616518]
Corp IBM. IBM SPSS statistics for windows, version 220. Armonk, NY: IBM Corp. 2013.
Heaton RK, Gladsjo JA, Palmer BW, Kuck J, Marcotte TD, Jeste DV. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry 2001; 58(1): 24-32.
[] [PMID: 11146755]
Herold CJ, Schmid LA, Lässer MM, Seidl U, Schröder J. Cognitive performance in patients with chronic schizophrenia across the lifespan. GeroPsych (Bern) 2017; 30(1): 35-44.
Ivarsson A-B, Carlsson M, Sidenvall B. Performance of occupations in daily life among individuals with severe mental disorders. Occup Ther Ment Health 2004; 20(2): 33-50.
Bowie CR, Reichenberg A, Patterson TL, Heaton RK, Harvey PD. Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms. Am J Psychiatry 2006; 163(3): 418-25.
[] [PMID: 16513862]
Elliott CS, Fiszdon JM. Comparison of self-report and performance-based measures of everyday functioning in individ-uals with schizophrenia: Implications for measure selection. Cogn Neuropsychiatry 2014; 19(6): 485-94.
[] [PMID: 24901357]
McClure MM, Bowie CR, Patterson TL, et al. Correlations of functional capacity and neuropsychological performance in older patients with schizophrenia: Evidence for specificity of relationships? Schizophr Res 2007; 89(1-3): 330-8.
[] [PMID: 16982175]
Evans JD, Heaton RK, Paulsen JS, Palmer BW, Patterson T, Jeste DV. The relationship of neuropsychological abilities to specific domains of functional capacity in older schizophrenia patients. Biol Psychiatry 2003; 53(5): 422-30.
[] [PMID: 12614995]
Palmer BW, Heaton RK, Gladsjo JA, et al. Heterogeneity in functional status among older outpatients with schizophre-nia: Employment history, living situation, and driving. Schizophr Res 2002; 55(3): 205-15.
[] [PMID: 12048144]
Addington J, McCleary L, Munroe-Blum H. Relationship between cognitive and social dysfunction in schizophrenia. Schizophr Res 1998; 34(1-2): 59-66.
[] [PMID: 9824877]
Villalta-Gil V, Vilaplana M, Ochoa S, et al. Neurocognitive performance and negative symptoms: Are they equal in ex-plaining disability in schizophrenia outpatients? Schizophr Res 2006; 87(1-3): 246-53.
[] [PMID: 16859898]
Saykin AJ, Shtasel DL, Gur RE, et al. Neuropsychological deficits in neuroleptic naive patients with first-episode schizo-phrenia. Arch Gen Psychiatry 1994; 51(2): 124-31.
[] [PMID: 7905258]
Bellack AS, Green MF, Cook JA, et al. Assessment of community functioning in people with schizophrenia and other severe mental illnesses: A white paper based on an NIMH-sponsored workshop. Schizophr Bull 2007; 33(3): 805-22.
[] [PMID: 16931542]

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