The relationships of personal resources with symptom severity and psychosocial functioning in persons with schizophrenia: results from the Italian Network for Research on Psychoses study

The relationships of personal resources with symptom severity and psychosocial functioning have never been tested systematically in a large sample of people with schizophrenia. We applied structural equation models to a sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim to identify, among a large set of personal resources, those that may have an association with symptom severity or psychosocial functioning. Several relevant demographic and clinical variables were considered concurrently. Poor service engagement and poor recovery style, as well as older age and younger age at onset, were related to greater symptom severity and poorer social functioning. Higher resilience and higher education were related to better social functioning only. Poor problem-focused coping and internalized stigma, as well as male gender and depression, were related to symptom severity only. The explored variables showed distinctive and partially independent associations with symptom severity and psychosocial functioning. A deeper understanding of these relationships may inform treatment decisions.

[1]  D. Roe,et al.  Coping With Psychosis: An Integrative Developmental Framework , 2006, The Journal of nervous and mental disease.

[2]  R. Kongsakon,et al.  Psychosocial functioning in schizophrenia: are some symptoms or demographic characteristics predictors across the functioning domains? , 2015, Neuropsychiatric disease and treatment.

[3]  A Hughes,et al.  Relationship Between Insight, Educational Background and Cognition in Schizophrenia , 1996, British Journal of Psychiatry.

[4]  Peter B. Jones,et al.  Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). , 2006, Archives of general psychiatry.

[5]  W. Nugent,et al.  Validation of a Clinical Measure of Self-Esteem , 1993 .

[6]  L. Phillips,et al.  Strategies used by psychotic individuals to cope with life stress and symptoms of illness: a systematic review , 2009, Anxiety, stress, and coping.

[7]  J. Kwon,et al.  The relationship between psychosocial functioning and resilience and negative symptoms in individuals at ultra-high risk for psychosis , 2013, The Australian and New Zealand journal of psychiatry.

[8]  P. Llorca,et al.  Factors involved in the level of functioning of patients with schizophrenia according to latent variable modeling , 2012, European Psychiatry.

[9]  P. Lysaker,et al.  Stigma, social function and symptoms in schizophrenia and schizoaffective disorder: Associations across 6 months , 2007, Psychiatry Research.

[10]  J. Livingston,et al.  Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. , 2010, Social science & medicine.

[11]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[12]  N. Poloni,et al.  The Italian version of ISOS and RSQ, two suitable scales for investigating recovery style from psychosis , 2010, Epidemiology and Psychiatric Sciences.

[13]  D. Roe,et al.  Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. , 2006, Schizophrenia bulletin.

[14]  D. Weinberger,et al.  Remission in schizophrenia: proposed criteria and rationale for consensus. , 2005, The American journal of psychiatry.

[15]  P. Stratta,et al.  The adolescent emotional coping after an earthquake: a risk factor for suicidal ideation. , 2014, Journal of adolescence.

[16]  D. R. Weinberger,et al.  Searching for a consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia , 2012, Schizophrenia Research.

[17]  A. Rudnick,et al.  Coping and schizophrenia: a re-analysis. , 2009, Archives of psychiatric nursing.

[18]  O. Hjemdal,et al.  Empirical Support for Resilience as More than the Counterpart and Absence of Vulnerability and Symptoms of Mental Disorder , 2009 .

[19]  D. Iosifescu The relation between mood, cognition and psychosocial functioning in psychiatric disorders , 2012, European Neuropsychopharmacology.

[20]  L. San,et al.  Psychiatrists’ perceptions of the clinical importance, assessment and management of patient functioning in schizophrenia in Europe, the Middle East and Africa , 2013, Annals of General Psychiatry.

[21]  John M. Davis,et al.  Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis , 2009, The Lancet.

[22]  H. Nasrallah,et al.  Reliability, validity and ability to detect change of the Personal and Social Performance scale in patients with stable schizophrenia , 2008, Psychiatry Research.

[23]  G. Juckel,et al.  Validation of the Personal and Social Performance (PSP) Scale in a German sample of acutely ill patients with schizophrenia , 2008, Schizophrenia Research.

[24]  P. Delespaul,et al.  Stereotype Awareness, Self-Esteem and Psychopathology in People with Psychosis , 2014, PloS one.

[25]  C. Carver,et al.  Assessing coping strategies: a theoretically based approach. , 1989, Journal of personality and social psychology.

[26]  Michelle P. Salyers,et al.  A prospective analysis of work in schizophrenia. , 2001, Schizophrenia bulletin.

[27]  T. Revenson,et al.  Does coping help? A reexamination of the relation between coping and mental health. , 1987, Journal of personality and social psychology.

[28]  M. Birchwood,et al.  A new scale (SES) to measure engagement with community mental health services , 2002, Journal of mental health.

[29]  J. Ritsher,et al.  Internalized stigma of mental illness: psychometric properties of a new measure , 2003, Psychiatry Research.

[30]  T. McGlashan,et al.  Integration and sealing over. Clinically distinct recovery styles from schizophrenia. , 1975, Archives of general psychiatry.

[31]  M. Lambert,et al.  Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. , 2006, The Journal of clinical psychiatry.

[32]  T. McGlashan Recovery Style from Mental Illness and Long-Term Outcome , 1987, The Journal of nervous and mental disease.

[33]  M. Lambert,et al.  Remission as perceived by people with schizophrenia, family members and psychiatrists , 2012, European Psychiatry.

[34]  D. Roe,et al.  Internalized stigma and quality of life among persons with severe mental illness: The mediating roles of self-esteem and hope , 2013, Psychiatry Research.

[35]  J. Addington,et al.  Assessing Depression in Schizophrenia: The Calgary Depression Scale , 1993, British Journal of Psychiatry.

[36]  M. Lambert,et al.  The assessment of quality of life in clinical practice in patients with schizophrenia , 2014, Dialogues in clinical neuroscience.

[37]  A. Torgalsbøen Sustaining full recovery in schizophrenia after 15 years: does resilience matter? , 2012, Clinical schizophrenia & related psychoses.

[38]  A. Rossi,et al.  The influence of illness‐related variables, personal resources and context‐related factors on real‐life functioning of people with schizophrenia , 2014, World psychiatry : official journal of the World Psychiatric Association.

[39]  C. Correll,et al.  Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions , 2013, World psychiatry : official journal of the World Psychiatric Association.

[40]  M. Figueira,et al.  Symptomatic remission in schizophrenia patients: Relationship with social functioning, quality of life, and neurocognitive performance , 2011, Schizophrenia Research.

[41]  Philip D. Harvey,et al.  Determinants of everyday outcomes in schizophrenia: The influences of cognitive impairment, functional capacity, and symptoms , 2009, Schizophrenia Research.

[42]  Philip D. Harvey,et al.  Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. , 2010, The American journal of psychiatry.

[43]  I. Modai,et al.  Quality of life and coping with schizophrenia symptoms , 2003, Quality of Life Research.

[44]  M. Birchwood,et al.  Early attachment experience and recovery from psychosis. , 1998, The British journal of clinical psychology.

[45]  M. Birchwood,et al.  Adapting to the challenge of psychosis: personal resilience and the use of sealing-over (avoidant) coping strategies , 2004, British Journal of Psychiatry.

[46]  O. Hjemdal,et al.  Resilience in relation to personality and intelligence , 2005, International journal of methods in psychiatric research.

[47]  G. Juckel,et al.  The illness and everyday living: close interplay of psychopathological syndromes and psychosocial functioning in chronic schizophrenia , 2011, European Archives of Psychiatry and Clinical Neuroscience.

[48]  D. Patrick,et al.  Reliability, validity and ability to detect change of the clinician-rated Personal and Social Performance scale in patients with acute symptoms of schizophrenia. , 2009, Current medical research and opinion.

[49]  J. Zauszniewski,et al.  Resilience in family members of persons with serious mental illness. , 2010, The Nursing clinics of North America.

[50]  S. Kapur,et al.  Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: Analysis of CATIE data , 2012, Schizophrenia Research.

[51]  B. Carpiniello,et al.  Gender Differences in Remission and Recovery of Schizophrenic and Schizoaffective Patients: Preliminary Results of a Prospective Cohort Study , 2012, Schizophrenia research and treatment.

[52]  P. Morosini,et al.  Development, reliability and acceptability of a new version of the DSM‐IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social funtioning , 2000, Acta psychiatrica Scandinavica.

[53]  J. Boyd,et al.  Internalized Stigma of Mental Illness (ISMI) scale: a multinational review. , 2014, Comprehensive psychiatry.

[54]  P. Delespaul,et al.  Symptomatic remission in psychosis and real-life functioning , 2012, British Journal of Psychiatry.

[55]  Herbert Y Meltzer,et al.  The role of cognition in vocational functioning in schizophrenia , 2000, Schizophrenia Research.

[56]  M. Figueira,et al.  Is personal and social functioning associated with subjective quality of life in schizophrenia patients living in the community? , 2011, European Archives of Psychiatry and Clinical Neuroscience.

[57]  T. Burns,et al.  Social functioning as an outcome measure in schizophrenia studies , 2007, Acta psychiatrica Scandinavica.

[58]  M. Lambert,et al.  Remitted but still impaired? Symptomatic versus functional remission in patients with schizophrenia , 2012, European Psychiatry.

[59]  L. Magliano,et al.  Burden on the families of patients with schizophrenia: results of the BIOMED I study , 1998, Social Psychiatry and Psychiatric Epidemiology.