Lifetime psychopathological dimensions, cognitive impairment and functional outcome in psychosis

Psychopathological symptoms and cognitive impairment are related to psychosocial functioning. However, the nature of the association of cognitive impairment with psychosocial functioning still remains under scrutiny. We aimed to examine the relationships of premorbid adjustment, lifetime psychopathological dimensions, and cognitive performance with the typical level of psychosocial functioning during the previous year. We assessed ninety patients with schizophrenia spectrum disorders and affective disorders with psychotic symptoms to collect data on premorbid adjustment, lifetime psychopathological dimensions, cognitive performance and psychosocial functioning. Sixty-five healthy volunteers were included as controls. Pearson's correlations and hierarchical regression analyses were performed to ascertain to what extent the aforementioned variables predicted psychosocial functioning. Functional domains were significantly correlated with most of the premorbid features, lifetime psychopathological dimensions and cognitive domains. However, lifetime negative symptoms were the best predictors of psychosocial functioning in the hierarchical regression analyses (explaining between 47 and 64% of the variance). For psychosocial outcome in patients with psychoses, lifetime negative symptoms showed a stronger predictive validity than cognitive impairment or premorbid adjustment.