Development and evaluation of a risk prediction model for social disability in schizophrenia patients

Schizophrenia is a severe mental disorder with a significant impact on social functioning. Social disability is common in patients, requiring a reliable prediction model for early intervention. This study aimed to develop and validate a risk prediction model for social disability in schizophrenia patients, focusing on key contributing factors.

A cross-sectional study that involved 473 schizophrenia patients was conducted between February and September 2021. Standardized assessments, including the Social Disability Screening Schedule, Brief Psychiatric Rating Scale, The Medication Adherence Report Scale, and Brief Assessment of Cognition in Schizophrenia, were administered. Logistic regression was employed to identify the independent risk factors for social disability, and the model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness-of-fit test.

Among the 473 participants (56.0% male, mean age = 29.31 ± 8.7 years old), 314 (66.4%) had a social disability. Significant differences in educational level, income, residence, and clinical characteristics were observed between the social disability and non-disability groups. The multivariate logistic regression analysis identified six independent risk factors for social disability: severity of psychiatric symptoms, medication adherence, cognitive function, perceived stigma, social support, and psychological capital. The final risk prediction model demonstrated strong discriminatory ability, with an AUC of 0.860 (95% CI: 0.820-0.899). The model exhibited high sensitivity (0.873) and specificity (0.868), with good calibration, as indicated by the Hosmer-Lemeshow test (X² = 5.746, p = 0.783).

The risk prediction model can effectively identify schizophrenia patients at high risk for social disability, supporting early and targeted interventions to improve outcomes.