Year: 2018
Type: article
Study design: Observational Study
Abstract: Background: Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD. Methods: Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan’s Disability Inventory. Results: In the final linear regression models, higher scores in the Paranoid (β= 0.471, p <.001, r2 = 0.273) and Cognitive (β = 0.325, p <.001, r2 = 0.180) symptomatic dimensions and lower scores in verbal memory (β = −0.273, p <.05, r2 = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= −0.337, p <.01, r2 = 0.158) and executive functions (β= −0.323, p <.01, r2 = 0.094) were significantly associated with higher self-perceived disability. Conclusions: Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD.
Source: European Psychiatry
Institutions: Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad de Granada, Complejo Hospitalario Universitario de Granada, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Bristol-Myers Squibb, Ministerio de Ciencia, Innovación y Universidades, European Commission, Ministerio de Economía y Competitividad, Ministerio de Ciencia e Innovación, Centro de Investigación Biomédica en Red de Salud Mental, Innovative Medicines Initiative, Horizon 2020 Framework Programme, Instituto de Salud Carlos III, European Regional Development Fund, FP7 Health
Awards: G1297764492, G2017605187, G2166927188, G2628364946, G3421866168, G4637685055, Translating neuroimaging findings from research into clinical practice, G4827590587, G4937468798, G5031224452, OPtimization of Treatment and Management of Schizophrenia in Europe (OPTiMiSE), G6844935297, G7114038015, Neuroimaging platform for characterisation of metabolic co-morbidities in psychotic disorders, European Network of National Schizophrenia Networks Studying Gene-Environment Interactions, Psychiatric Ratings using Intermediate Stratified Markers - Sofia ref.: 115916, G85705433, G8824911526
OpenAlex ID: W2899019167