Abstract
Background
This study sought to determine the relative importance of cognitive measures in predicting
various domains of everyday functional capacity in older outpatients with schizophrenia.
Methods
Ninety-three psychiatry outpatients with diagnoses of schizophrenia and schizoaffective
disorders underwent a comprehensive neuropsychiatric evaluation, including neuropsychological
testing and clinical ratings of psychopathology. Functional capacity was assessed
with the Direct Assessment of Functional Status, a performance measure of basic and
instrumental activities of daily living (ADLs/IADLs).
Results
Neuropsychological performance significantly predicted most ADLs/IADLs measured, except
simple eating behaviors, time orientation, and grooming. Lower educational level and
negative symptoms also were associated with worse functional capacity, whereas positive
symptoms and depressed mood were not. Measures of cognitive functioning accounted
for more variance in functional capacity than did psychiatric ratings of symptoms,
and multiple regression analyses demonstrated that neuropsychological performance
was predictive of functional capacity, over and above clinical symptoms. No specific
cognitive domains were differentially predictive of specific domains of functional
capacity.
Conclusions
Neurocognitive abilities were more predictive of functional capacity than level of
clinical symptoms; however, these abilities were not specific predictors of functioning.
This is consistent with findings of relatively generalized, intercorrelated cognitive
impairment in schizophrenia and multiply determined domains of everyday functioning.
Keywords
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Article info
Publication history
Accepted:
June 13,
2002
Received in revised form:
June 11,
2002
Received:
September 12,
2001
Identification
Copyright
© 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
