The interplay among psychopathology, personal resources, context-related factors and real-life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and non-recovered patients.

Autor: Galderisi S; Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy., Rucci P; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Mucci A; Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy., Rossi A; Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Rocca P; Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy., Bertolino A; Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy., Aguglia E; Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy., Amore M; Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy., Bellomo A; Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy., Bozzatello P; Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy., Bucci P; Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy., Carpiniello B; Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy., Collantoni E; Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy., Cuomo A; Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy., Dell'Osso L; Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy., Di Fabio F; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy., di Giannantonio M; Department of Neuroscience and Imaging, G. D'Annunzio University, Chieti, Italy., Gibertoni D; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Giordano GM; Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy., Marchesi C; Psychiatry Unit, Department of Neuroscience, University of Parma, Parma, Italy., Monteleone P; Section of Neuroscience, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy., Oldani L; Department of Psychiatry, University of Milan, Milan, Italy., Pompili M; Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy., Roncone R; Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy., Rossi R; Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Siracusano A; Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy., Vita A; Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy.; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy., Zeppegno P; Psychiatric Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy., Maj M; Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Jazyk: angličtina
Zdroj: World psychiatry : official journal of the World Psychiatric Association (WPA) [World Psychiatry] 2020 Feb; Vol. 19 (1), pp. 81-91.
DOI: 10.1002/wps.20700
Abstrakt: Improving real-life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses previously explored, by using network analysis, the interplay among illness-related variables, personal resources, context-related factors and real-life functioning in a large sample of patients with schizophrenia. The same research network has now completed a 4-year follow-up of the original sample. In the present study, we used network analysis to test whether the pattern of relationships among all variables investigated at baseline was similar at follow-up. In addition, we compared the network structure of patients who were classified as recovered at follow-up versus those who did not recover. Six hundred eighteen subjects recruited at baseline could be assessed in the follow-up study. The network structure did not change significantly from baseline to follow-up, and the overall strength of the connections among variables increased slightly, but not significantly. Functional capacity and everyday life skills had a high betweenness and closeness in the network at follow-up, as they had at baseline, while psychopathological variables remained more peripheral. The network structure and connectivity of non-recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other's activation, contributing to poor outcome in schizophrenia. Early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self-reinforcing networks of symptoms and dysfunctions in people with schizophrenia.
(© 2020 World Psychiatric Association.)
Databáze: MEDLINE
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