The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia

Silvana Galderisi, Alessandro Rossi, Paola Rocca, Alessandro Bertolino, Armida Mucci, Paola Bucci, Paola Rucci, Dino Gibertoni, Eugenio Aguglia, Mario Amore, Antonello Bellomo, Massimo Biondi, Roberto Brugnoli, Liliana Dell'Osso, Diana De Ronchi, Gabriella Di Emidio, Massimo Di Giannantonio, Andrea Fagiolini, Carlo Marchesi, Palmiero MonteleoneLucio Oldani, Federica Pinna, Rita Roncone, Emilio Sacchetti, Paolo Santonastaso, Alberto Siracusano, Antonio Vita, Patrizia Zeppegno, Mario Maj, Marcello Chieffi, Stefania De Simone, Francesco De Riso, Rosa Giugliano, Giuseppe Piegari, Annarita Vignapiano, Grazia Caforio, Marina Mancini, Lucia Colagiorgio, Stefano Porcelli, Raffaele Salfi, Oriana Bianchini, Alessandro Galluzzo, Stefano Barlati, Bernardo Carpiniello, Francesca Fatteri, Silvia Lostia Di Santa Sofia, Dario Cannavò, Giuseppe Minutolo, Maria Signorelli, Giovanni Martinotti, Giuseppe Di Iorio, Tiziano Acciavatti, Stefano Pallanti, Carlo Faravelli, Mario Altamura, Eleonora Stella, Daniele Marasco, Pietro Calcagno, Matteo Respino, Valentina Marozzi, Ilaria Riccardi, Alberto Collazzoni, Paolo Stratta, Laura Giusti, Donatella Ussorio, Ida Delauretis, Marta Serati, Alice Caldiroli, Carlotta Palazzo, Felice Iasevoli, Carla Gramaglia, Sabrina Gili, Eleonora Gattoni, Elena Tenconi, Valeria Giannunzio, Francesco Monaco, Chiara De Panfilis, Annalisa Camerlengo, Paolo Ossola, Paola Landi, Grazia Rutigliano, Irene Pergentini, Mauro Mauri, Fabio Di Fabio, Chiara Torti, Antonino Buzzanca, Anna Comparelli, Antonella De Carolis, Valentina Corigliano, Giorgio Di Lorenzo, Cinzia Niolu, Alfonso Troisi, Giulio Corrivetti, Gaetano Pinto, Ferdinando Diasco, Arianna Goracci, Simone Bolognesi, Elisa Borghini, Cristiana Montemagni, Tiziana Frieri, Nadia Birindelli

Research output: Contribution to journalArticle

Abstract

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia.

Original languageEnglish
Pages (from-to)275-287
Number of pages13
JournalWorld Psychiatry
Volume13
Issue number3
DOIs
Publication statusPublished - 2014

    Fingerprint

Keywords

  • Avolition
  • Disorganization
  • Engagement with mental health services
  • Internalized stigma
  • Neurocognition
  • Personal resources
  • Positive symptoms
  • Real-life functioning
  • Resilience
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Phychiatric Mental Health

Cite this

Galderisi, S., Rossi, A., Rocca, P., Bertolino, A., Mucci, A., Bucci, P., Rucci, P., Gibertoni, D., Aguglia, E., Amore, M., Bellomo, A., Biondi, M., Brugnoli, R., Dell'Osso, L., De Ronchi, D., Di Emidio, G., Di Giannantonio, M., Fagiolini, A., Marchesi, C., ... Birindelli, N. (2014). The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia. World Psychiatry, 13(3), 275-287. https://doi.org/10.1002/wps.20167