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Long M, Stansfeld JL, Davies N, Crellin NE, Moncrieff J. A systematic review of social functioning outcome measures in schizophrenia with a focus on suitability for intervention research. Schizophr Res 2022; 241:275-291. [PMID: 35217356 DOI: 10.1016/j.schres.2022.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
Social functioning is an important part of recovery and a key treatment target in clinical research in schizophrenia. Evaluating and comparing interventions is challenged by the choice of many measures which focus on different aspects of functioning, with little to guide selection. This results in difficulties comparing outcomes of treatment where studies have used different measures. To improve the measurement of social functioning in intervention research, we aimed to provide practical information on suitability of measures. We conducted a systematic review of measures developed or psychometrically evaluated since 2007, and assessed and discussed the structure, content, quality, and the use of the measures in intervention research. Thirty-two measures of social functioning and 22 validation papers were identified. Measures included structured questionnaires, semi-structured interviews, and assessment of performance on specific tasks. The content of measures was organised into eight categories, which are in order of frequency with which they were covered by measures: activities of daily living, productive activity, relationships, leisure activities, cognition, anti-social behaviour, psychosis symptoms and self-esteem and empowerment. In terms of quality, most measures were rated as moderate, with the Personal and Social Performance Scale gaining the highest rating. However, there was little data on responsiveness of measures, or how they compare to objective or 'real-world' indicators of functioning. The Social Functioning Scale and Personal and Social Performance Scale have been most frequently used in intervention studies to date. Future research should aim to provide further data on psychometric properties relevant to intervention research.
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Affiliation(s)
- Maria Long
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Research and Development, North East London NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland.
| | - Jacki L Stansfeld
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Research and Development, North East London NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Nathan Davies
- Research Department of Primary Care and Population Health, University College London, United Kingdom of Great Britain and Northern Ireland
| | - Nadia E Crellin
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Nuffield Trust, United Kingdom of Great Britain and Northern Ireland
| | - Joanna Moncrieff
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Research and Development, North East London NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
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Yazici E, Mutu Pek T, Guzel D, Yazici AB, Akcay Ciner O, Erol A. Klotho, vitamin D and homocysteine levels during acute episode and remission periods in schizophrenia patients. Nord J Psychiatry 2019; 73:178-184. [PMID: 30896269 DOI: 10.1080/08039488.2019.1582697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM Neurodegenerative processes are effective in schizophrenia. However, the underlying causes of the symptoms and associated factors have not yet been fully elucidated. Recent research has focused on the relationship between neurodegeneration and vitamin D, Klotho and homocysteine levels. In this study, we aimed to investigate this relationship in schizophrenia. METHOD This study included 30 schizophrenic inpatients, 30 schizophrenic outpatients in remission and 28 healthy volunteers as the control group. The psychiatric diagnoses of our patients were evaluated according to DSM-IV criteria. The Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Clinical Global Impression (CGI) scale were used for clinical measurements. Serum Klotho, homocysteine, vitamin D, vitamin B12 and folic acid levels were analyzed using ELISA and compared with clinical properties. RESULTS The PANSS scores and CGI scores were higher in schizophrenic inpatients than outpatients, and the GAF scores were lower (p < 0.05). Three groups were compared for Klotho, homocysteine and vitamin D serum levels; Klotho levels were elevated but the difference was not statistically significant (p > 0.05). However, vitamin B12, folic acid and homocysteine levels were higher in schizophrenic patients than the control group (p < 0.05). CONCLUSIONS Higher levels of homocysteine with concomitant higher levels of vitamin B12 and folic acid suggest a relationship of this pathway with schizophrenia. Differences in Klotho levels were elevated but it was not significant. Replication studies to investigate probable associations with larger samples are needed.
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Affiliation(s)
- Esra Yazici
- a Medical Faculty, Department of Psychiatry , Sakarya University , Sakarya , Turkey
| | - Tugba Mutu Pek
- a Medical Faculty, Department of Psychiatry , Sakarya University , Sakarya , Turkey
| | - Derya Guzel
- a Medical Faculty, Department of Psychiatry , Sakarya University , Sakarya , Turkey
| | - Ahmet Bulent Yazici
- a Medical Faculty, Department of Psychiatry , Sakarya University , Sakarya , Turkey
| | - Ozlem Akcay Ciner
- a Medical Faculty, Department of Psychiatry , Sakarya University , Sakarya , Turkey
| | - Atila Erol
- a Medical Faculty, Department of Psychiatry , Sakarya University , Sakarya , Turkey
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Joseph J, Kremen WS, Franz CE, Glatt SJ, van de Leemput J, Chandler SD, Tsuang MT, Twamley EW. Predictors of current functioning and functional decline in schizophrenia. Schizophr Res 2017; 188:158-164. [PMID: 28139356 PMCID: PMC5529271 DOI: 10.1016/j.schres.2017.01.038] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 12/19/2022]
Abstract
Positive, negative, and cognitive symptoms of schizophrenia may affect functional outcomes. However, these factors alone do not account for a large percentage of variance in outcomes. We investigated demographic, cognitive, symptom, and functional capacity predictors of current functional status in 280 outpatients with schizophrenia or schizoaffective disorder. Functional decline over the lifespan was also examined in a subset of participants. Stepwise regressions modeled predictors of current functional status and functional decline as measured by the Assessment of Lifespan Functioning Attainment (ALFA). ALFA functional domains included paid employment, independence in living situation, romantic relationships, close friendships, and recreational engagement. More severe depressive symptoms were consistently associated with worse current community integration (lower levels of close friendships and recreational engagement). Better working memory performance was associated with higher rates of current paid employment. There were no consistent modifiable predictors of decline in functioning, but women reported less functional decline in the domains of employment and close friendships than men. Better cognitive performance was associated with less decline in living independence and romantic relationships, but more decline in paid employment and recreational engagement. Increased assessment and treatment of comorbid depressive symptoms may improve functional outcomes in people with schizophrenia.
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Affiliation(s)
- Jamie Joseph
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - William S Kremen
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
| | - Carol E Franz
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Stephen J Glatt
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory, Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams Street, 3710 Neuroscience Research Building, Syracuse, NY 13210, USA
| | - Joyce van de Leemput
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Sharon D Chandler
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Ming T Tsuang
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA; Institute for Genomic Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Elizabeth W Twamley
- Center for Behavioral Genomics, Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
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