Is change over time in psychotic symptoms related to social functioning?

Sascha Kwakernaak*, GROUP investigators, Wiepke Cahn, Richard Janssen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective:
In psychosis, treatment often focuses on symptom reduction whereas social functioning is also essential. In this study, we investigate positive psychotic symptoms and medication use in relation to social functioning over a 3-year time-period in 531 patients diagnosed with psychosis. Furthermore, relations of positive symptoms with needs for care and quality of life were also investigated.

Method:
Using repeated measures analysis, changes were measured over time. Hereafter, mixed model analyses were performed to determine the associations of social functioning, needs for care, and quality of life with psychotic symptoms and patient characteristics. Finally, we assessed differences in symptoms and medication dose between those with an increase and those with a decrease in social functioning.

Results:
Patients significantly improved in social functioning, while psychotic symptoms increased. Improvement in social functioning was associated with younger age, higher IQ, and lower social functioning at T1, but not with positive symptoms. Also, improvement in social functioning was found to be related to a decrease in the dose of clozapine. Improvement in social functioning occurs despite worsening of positive symptoms.

Conclusions:
The findings suggest the need to further explore the relation between symptomatology, social functioning, and medication use. In the treatment of psychotic disorders, one should reconsider the strong focus on reducing psychotic symptoms. The current focus needs to shift much more toward improving functional outcome, especially when the patient expresses a desire for change in this respect.
Original languageEnglish
Number of pages9
JournalInternational Journal of Social Psychiatry
DOIs
Publication statusE-pub ahead of print - 2021

Keywords

  • 1ST-EPISODE PSYCHOSIS
  • ADJUSTMENT
  • ASSOCIATIONS
  • COGNITION
  • FOLLOW-UP
  • NEGATIVE-SYNDROME-SCALE
  • Non-affective psychosis
  • QUALITY-OF-LIFE
  • REMISSION
  • SCHIZOPHRENIA
  • VALIDATION
  • needs for care
  • positive psychotic symptoms
  • quality of life
  • social functioning

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