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Decrease of functioning in remitted and non-remitted patients 16 years after a first-episode schizophrenia.

Carlo Marchesi1, Andrea Affaticati, Alberto Monici

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Schizophrenia patients experience functional decline over time, even with symptom remission. Negative symptoms significantly impact long-term functioning and social occupational functioning assessment scale scores.

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Area of Science:

  • Psychiatry
  • Neuroscience
  • Clinical Psychology

Background:

  • Functional outcomes in schizophrenia are often linked to symptomatic remission.
  • Previous research relied on short-term or cross-sectional data.

Purpose of the Study:

  • To investigate the long-term association between symptomatic remission and functional outcomes in schizophrenia.
  • To identify predictors of functional decline in schizophrenia over 16 years.

Main Methods:

  • Longitudinal study of 48 schizophrenia patients.
  • Assessment using the Positive and Negative Symptoms Scale and Social and Occupational Functioning Assessment Scale (SOFAS) at baseline and 16-year follow-up.
  • Classification of patients into remitters (R) and non-remitters (NR) based on established criteria.

Main Results:

  • Remitters (R) showed better baseline functioning and lower illness severity than non-remitters (NR).
  • Both groups experienced functional decline, with NR showing a greater reduction (over twofold).
  • Baseline SOFAS scores and lower negative symptom severity at follow-up predicted better long-term SOFAS scores.

Conclusions:

  • Schizophrenia is associated with progressive functional decline irrespective of symptomatic remission status.
  • Negative symptoms play a crucial role in long-term functional impairment in schizophrenia.
  • Early functional status and symptom severity are key factors influencing long-term outcomes.