Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-16T11:03:46.446Z Has data issue: false hasContentIssue false
  • English
  • Français

Patient outcomes in schizophrenia II: the impact of cognition

Published online by Cambridge University Press:  16 April 2020

Alex Hofer ,
Susanne Baumgartner ,
Thomas Bodner ,
Monika Edlinger ,
Martina Hummer ,
Georg Kemmler ,
Maria A. Rettenbacher  and
W. Wolfgang Fleischhacker
Alex Hofer*
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
Susanne Baumgartner
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
Thomas Bodner
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
Monika Edlinger
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
Martina Hummer
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
Georg Kemmler
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
Maria A. Rettenbacher
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
W. Wolfgang Fleischhacker
Affiliation:
Department of Biological Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020Innsbruck, Austria
*
*Corresponding author. Tel.: +43 512 504 23669; fax: +43 512 50425267. E-mail address:a.hofer@uibk.ac.at (A. Hofer).
Get access

Abstract

Background

Cognitive dysfunction is increasingly considered to be the strongest clinical predictor of poor long-term outcome in schizophrenia. Associations have been found between the severity of cognitive deficits and social dysfunction, impairments in independent living, occupational limitations, and disturbances in quality of life (QOL).

Methods

In this cross-sectional study, the relationships of cognitive deficits and treatment outcomes in terms of QOL, needs, and psychosocial functioning were examined in 60 outpatients with schizophrenia who had a duration of illness over 2 years and had been treated with either clozapine or olanzapine for at least 6 months.

Results

The present study suggests that cognitive functioning might be a predictor of work functioning/independent living outcome in stabilized patients with schizophrenia: deficits of visual memory and working memory were negatively associated with occupational functioning, and older patients lived independently and/or in a stable partnership more often. The patients' assessments of QOL and needs for care did not show any significant associations with cognitive functioning.

Discussion

These findings suggest that cognitive functioning is a key determinant of work functioning/independent living for stable outpatients with schizophrenia.

Keywords

SchizophreniaCognitionOutcomeNeedsQuality of lifeEmployment
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 5-6 , August 2005 , pp. 395 - 402
Copyright
Copyright ©Elsevier SAS 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J., Addington, D.Neurocognitive and social functioning in schizophrenia. Schizophr. Bull. 1999; 25: 173–182CrossRefGoogle Scholar
Aschenberger, S., Tucher, O., Lange, K.W.Regensburger Wörtflüssigkeits-Test. Göttingen: Hogrefe Verlag für Psychologie; 2000Google Scholar
Benton, A.S., Spreen, O.Der Benton Test. Handbuch: 7 Auflage; 1996Google Scholar
Brekke, J.S., Levin, S., Wolkon, G., Sobel, G., Slade, B.Psychosocial functioning and subjective experience in schizophrenia. Schizophr. Bull. 1993; 19: 599–608CrossRefGoogle Scholar
Brekke, J.S., Kohrt, B., Green, M.F.Neuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia. Schizophr. Bull. 2001; 27: 697–708CrossRefGoogle Scholar
Browne, S., Roe, M., Lane, A., Gervin, M., Morris, M., Kinsella, A., et al.Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology, and tardive dyskinesia. Acta Psychiatr. Scand. 1996; 94: 118–124CrossRefGoogle ScholarPubMed
Corrigan, P.W., Reinke, R.R., Landsberger, S.A., Charate, A., Toombs, G.A.The effects of atypical antipsychotic medications on psychosocial outcomes. Schizophr. Res. 2003; 63: 97–101CrossRefGoogle ScholarPubMed
Delis, D.C., Kramer, J.H., Kaplan, E., Ober, B.A.California verbal learning and memory test (Manual) San Antonio, TX: Psychological Corporation; 1987Google Scholar
Dillon, W.R., Goldstein, M.Multivariate analysis. Methods and applications New York: Wiley; 1984Google Scholar
Fleischhacker, W.W.Pharmacological treatment of schizophrenia: a review. Maj, M.Sartorius, N.Schizophrenia. WPA Series evidence and experience in psychiatry Chichester, NY, Weinheim, Brisbane, Singapore, Toronto: Wiley; 2002.75–113Google Scholar
Green, M.F.What are the functional consequences of neurocognitive deficits in schizophrenia? Am. J. Psychiatry 1996; 153: 321–330Google Scholar
Green, M.F., Kern, R.S., Braff, D.L., Mintz, J.Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr. Bull. 2000; 26: 119–136CrossRefGoogle ScholarPubMed
Hamilton, S.H., Edgell, E.T., Revicki, D.A., Breier, A.Functional outcomes in schizophrenia: a comparison of olanzapine and haloperidol in a European sample. Clin. Psychopharmacol. 2000; 15: 245–255CrossRefGoogle Scholar
Harvey, P.D., Green, M.F., Keefe, R.S.E., Velligan, D.I.Cognitive functioning in schizophrenia: a consensus statement on its role in the definition and evaluation of effective treatments for the illness. J. Clin. Psychiatry 2004; 65: 361–372CrossRefGoogle ScholarPubMed
Heaton, R.K., Chelune, G.J., Taley, J.L., Kay, G.G., Curtiss, G.Wisconsin Card Sorting Test manual: revised and expanded Odessa, FL: Psychological Assessment Resources; 1993Google Scholar
Hofer, A., Kemmler, G., Eder, U., Edlinger, M., Hummer, M., Fleischhacker, W.W.Quality of life in schizophrenia: the impact of psychopathology, drug attitude and side effects. J. Clin. Psychiatry 2004; 65: 932–939CrossRefGoogle ScholarPubMed
Hofer, A., Baumgartner, S., Edlinger, M., Hummer, M., Kemmler, G., Rettenbacher, M.A., et al.Patient outcomes in schizophrenia I: the impact of sociodemographic variables, psychopathology, and side effects. Eur Psychiatry 20 2005(in press)CrossRefGoogle Scholar
Karow, A., Naber, D.Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacology (Berlin) 2002; 162: 3–10CrossRefGoogle ScholarPubMed
Kay, S.R., Fiszbein, A., Opler, L.A.The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr. Bull. 1987; 13: 261–276CrossRefGoogle Scholar
Kemmler, G., Holzner, B., Neudorfer, C., Meise, U., Hinterhuber, H.General life satisfaction and domain-specific quality of life in chronic schizophrenic patients. Qual. Life Res. 1997; 6: 265–273CrossRefGoogle ScholarPubMed
Landau, S., Everitt, B.S.A handbook of statistical analyses using SPSS London: Chapman and Hall; 2004Google Scholar
Lehrl, S.Manual zum MWT-B Erlangen: Verlag Dr. med. D. Straube; 1977Google Scholar
Leung, A., Chue, P.Sex differences in schizophrenia, a review of the literature. Acta Psychiatr. Scand. 2000; 101: 3–38CrossRefGoogle Scholar
Lindenmayer, J.P., Bernstein-Hyman, R., Grochowski, S.Five-factor model of schizophrenia. J. Nerv. Ment. Dis. 1994; 182: 631–638CrossRefGoogle ScholarPubMed
Lindenmayer, J.P., Grochowski, S., Hyman, R.B.Five factor model of schizophrenia: replication across samples. Schizophr. Res. 1995; 14: 229–234CrossRefGoogle ScholarPubMed
Littrell, K.H., Petty, R.G., Hilligoss, N.M., Kirshner, C.D., Johnson, C.G.Improvement in social cognition in patients with schizophrenia associated with treatment with olanzapine. Schizophr. Res. 2004; 66: 201–202CrossRefGoogle ScholarPubMed
McGurk, S., Moriarty, P.J., Harvey, P.D., Parrella, M., White, L., Davis, K.L.The longitudinal relationship of clinical symptoms, cognitive functioning, and adaptive life in geriatric schizophrenia. Schizophr. Res. 2000; 42: 47–55CrossRefGoogle ScholarPubMed
Priebe, S., Heinze, M., Jäkel, A.Berliner Bedürfnisinventar (BeBI) Abteilung für Sozialpsychiatrie, FU; 1993Google Scholar
Rempfer, M.V., Hamera, E.K., Brown, C.E., Cromwell, R.L.The relations between cognition and the independent living skill of shopping in people with schizophrenia. Psychiatry Res. 2003; 117: 103–112CrossRefGoogle ScholarPubMed
Sartorius, N., Fleischhacker, W.W., Gjerris, U., Kern, U., Knapp, M., Leonard, B.E., et al.The usefulness and use of second generation antipsychotic medications—an update. Curr. Opin. Psychiatry 16Suppl 12003 1–44Google Scholar
Sharma, T., Antonova, L.Cognitive function in schizophrenia. Deficits, functional consequences, and future treatment. Psychiatr. Clin. North Am. 2003; 26: 25–40CrossRefGoogle ScholarPubMed
Sharma, T., Hughes, C., Soni, W., Kumari, V.Cognitive effects of olanzapine and clozapine treatment in chronic schizophrenia. Psychopharmacology (Berlin) 2003; 169: 398–403CrossRefGoogle ScholarPubMed
Slade, M., Thornicroft, G., Loftus, L., Phelan, M., Wykes, T.CAN: Camberwell Assessment of Need Scales London: Gaskell; 1999.Google Scholar
The WHOQOL Group Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol. Med. 1998; 28: 551–558CrossRefGoogle Scholar
Velligan, D.I., Mahurin, R.K., Diamond, P.L., Hazleton, B.C., Eckert, S.L., Miller, A.L.The functional significance of symptomatology and cognitive function in schizophrenia. Schizophr. Res. 1997; 25: 21–31CrossRefGoogle Scholar
Velligan, D.I., Bow-Thomas, C.C., Mahurin, R.K., Miller, A.L., Halgunseth, L.C.Do specific neurocognitive deficits predict specific domains of community function in schizophrenia? J. Nerv. Ment. Dis. 2000; 188: 518–524CrossRefGoogle Scholar
Weiden, P., Mackell, J. Lecture held at the 152nd Annual Meeting of the APA, Washington, DC 1999May 15–20Google Scholar
Weiss, E.M., Bilder, R.M., Fleischhacker, W.W.The effects of second-generation antipsychotics on cognitive functioning and psychosocial outcome in schizophrenia. Psychopharmacology (Berlin) 2002; 162: 11–17CrossRefGoogle Scholar
Zimmermann, P., Fimm, B. Testbatterie zur Aufmerksamkeitsprüfung (TAP), Version 1.7. Herzogenrath: Vera Fimm/Psychologische Testsysteme 2002Google Scholar
Submit a response

Comments

No Comments have been published for this article.