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

140 Citations (Scopus)

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

Schizophrenia
Independent Living
Pensions
Structural Models
Mental Health Services
Cognition
Motivation
Depression
Therapeutics

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

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

In: World Psychiatry, Vol. 13, No. 3, 2014, p. 275-287.

Research output: Contribution to journalArticle

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, Monteleone, P, Oldani, L, Pinna, F, Roncone, R, Sacchetti, E, Santonastaso, P, Siracusano, A, Vita, A, Zeppegno, P, Maj, M, Chieffi, M, De Simone, S, De Riso, F, Giugliano, R, Piegari, G, Vignapiano, A, Caforio, G, Mancini, M, Colagiorgio, L, Porcelli, S, Salfi, R, Bianchini, O, Galluzzo, A, Barlati, S, Carpiniello, B, Fatteri, F, Di Santa Sofia, SL, Cannavò, D, Minutolo, G, Signorelli, M, Martinotti, G, Di Iorio, G, Acciavatti, T, Pallanti, S, Faravelli, C, Altamura, M, Stella, E, Marasco, D, Calcagno, P, Respino, M, Marozzi, V, Riccardi, I, Collazzoni, A, Stratta, P, Giusti, L, Ussorio, D, Delauretis, I, Serati, M, Caldiroli, A, Palazzo, C, Iasevoli, F, Gramaglia, C, Gili, S, Gattoni, E, Tenconi, E, Giannunzio, V, Monaco, F, De Panfilis, C, Camerlengo, A, Ossola, P, Landi, P, Rutigliano, G, Pergentini, I, Mauri, M, Di Fabio, F, Torti, C, Buzzanca, A, Comparelli, A, De Carolis, A, Corigliano, V, Di Lorenzo, G, Niolu, C, Troisi, A, Corrivetti, G, Pinto, G, Diasco, F, Goracci, A, Bolognesi, S, Borghini, E, Montemagni, C, Frieri, T & 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, vol. 13, no. 3, pp. 275-287. https://doi.org/10.1002/wps.20167
Galderisi, Silvana ; Rossi, Alessandro ; Rocca, Paola ; Bertolino, Alessandro ; Mucci, Armida ; Bucci, Paola ; Rucci, Paola ; Gibertoni, Dino ; Aguglia, Eugenio ; Amore, Mario ; Bellomo, Antonello ; Biondi, Massimo ; Brugnoli, Roberto ; Dell'Osso, Liliana ; De Ronchi, Diana ; Di Emidio, Gabriella ; Di Giannantonio, Massimo ; Fagiolini, Andrea ; Marchesi, Carlo ; Monteleone, Palmiero ; Oldani, Lucio ; Pinna, Federica ; Roncone, Rita ; Sacchetti, Emilio ; Santonastaso, Paolo ; Siracusano, Alberto ; Vita, Antonio ; Zeppegno, Patrizia ; Maj, Mario ; Chieffi, Marcello ; De Simone, Stefania ; De Riso, Francesco ; Giugliano, Rosa ; Piegari, Giuseppe ; Vignapiano, Annarita ; Caforio, Grazia ; Mancini, Marina ; Colagiorgio, Lucia ; Porcelli, Stefano ; Salfi, Raffaele ; Bianchini, Oriana ; Galluzzo, Alessandro ; Barlati, Stefano ; Carpiniello, Bernardo ; Fatteri, Francesca ; Di Santa Sofia, Silvia Lostia ; Cannavò, Dario ; Minutolo, Giuseppe ; Signorelli, Maria ; Martinotti, Giovanni ; Di Iorio, Giuseppe ; Acciavatti, Tiziano ; Pallanti, Stefano ; Faravelli, Carlo ; Altamura, Mario ; Stella, Eleonora ; Marasco, Daniele ; Calcagno, Pietro ; Respino, Matteo ; Marozzi, Valentina ; Riccardi, Ilaria ; Collazzoni, Alberto ; Stratta, Paolo ; Giusti, Laura ; Ussorio, Donatella ; Delauretis, Ida ; Serati, Marta ; Caldiroli, Alice ; Palazzo, Carlotta ; Iasevoli, Felice ; Gramaglia, Carla ; Gili, Sabrina ; Gattoni, Eleonora ; Tenconi, Elena ; Giannunzio, Valeria ; Monaco, Francesco ; De Panfilis, Chiara ; Camerlengo, Annalisa ; Ossola, Paolo ; Landi, Paola ; Rutigliano, Grazia ; Pergentini, Irene ; Mauri, Mauro ; Di Fabio, Fabio ; Torti, Chiara ; Buzzanca, Antonino ; Comparelli, Anna ; De Carolis, Antonella ; Corigliano, Valentina ; Di Lorenzo, Giorgio ; Niolu, Cinzia ; Troisi, Alfonso ; Corrivetti, Giulio ; Pinto, Gaetano ; Diasco, Ferdinando ; Goracci, Arianna ; Bolognesi, Simone ; Borghini, Elisa ; Montemagni, Cristiana ; Frieri, Tiziana ; Birindelli, Nadia. / The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia. In: World Psychiatry. 2014 ; Vol. 13, No. 3. pp. 275-287.
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AU - Rocca, Paola

AU - Bertolino, Alessandro

AU - Mucci, Armida

AU - Bucci, Paola

AU - Rucci, Paola

AU - Gibertoni, Dino

AU - Aguglia, Eugenio

AU - Amore, Mario

AU - Bellomo, Antonello

AU - Biondi, Massimo

AU - Brugnoli, Roberto

AU - Dell'Osso, Liliana

AU - De Ronchi, Diana

AU - Di Emidio, Gabriella

AU - Di Giannantonio, Massimo

AU - Fagiolini, Andrea

AU - Marchesi, Carlo

AU - Monteleone, Palmiero

AU - Oldani, Lucio

AU - Pinna, Federica

AU - Roncone, Rita

AU - Sacchetti, Emilio

AU - Santonastaso, Paolo

AU - Siracusano, Alberto

AU - Vita, Antonio

AU - Zeppegno, Patrizia

AU - Maj, Mario

AU - Chieffi, Marcello

AU - De Simone, Stefania

AU - De Riso, Francesco

AU - Giugliano, Rosa

AU - Piegari, Giuseppe

AU - Vignapiano, Annarita

AU - Caforio, Grazia

AU - Mancini, Marina

AU - Colagiorgio, Lucia

AU - Porcelli, Stefano

AU - Salfi, Raffaele

AU - Bianchini, Oriana

AU - Galluzzo, Alessandro

AU - Barlati, Stefano

AU - Carpiniello, Bernardo

AU - Fatteri, Francesca

AU - Di Santa Sofia, Silvia Lostia

AU - Cannavò, Dario

AU - Minutolo, Giuseppe

AU - Signorelli, Maria

AU - Martinotti, Giovanni

AU - Di Iorio, Giuseppe

AU - Acciavatti, Tiziano

AU - Pallanti, Stefano

AU - Faravelli, Carlo

AU - Altamura, Mario

AU - Stella, Eleonora

AU - Marasco, Daniele

AU - Calcagno, Pietro

AU - Respino, Matteo

AU - Marozzi, Valentina

AU - Riccardi, Ilaria

AU - Collazzoni, Alberto

AU - Stratta, Paolo

AU - Giusti, Laura

AU - Ussorio, Donatella

AU - Delauretis, Ida

AU - Serati, Marta

AU - Caldiroli, Alice

AU - Palazzo, Carlotta

AU - Iasevoli, Felice

AU - Gramaglia, Carla

AU - Gili, Sabrina

AU - Gattoni, Eleonora

AU - Tenconi, Elena

AU - Giannunzio, Valeria

AU - Monaco, Francesco

AU - De Panfilis, Chiara

AU - Camerlengo, Annalisa

AU - Ossola, Paolo

AU - Landi, Paola

AU - Rutigliano, Grazia

AU - Pergentini, Irene

AU - Mauri, Mauro

AU - Di Fabio, Fabio

AU - Torti, Chiara

AU - Buzzanca, Antonino

AU - Comparelli, Anna

AU - De Carolis, Antonella

AU - Corigliano, Valentina

AU - Di Lorenzo, Giorgio

AU - Niolu, Cinzia

AU - Troisi, Alfonso

AU - Corrivetti, Giulio

AU - Pinto, Gaetano

AU - Diasco, Ferdinando

AU - Goracci, Arianna

AU - Bolognesi, Simone

AU - Borghini, Elisa

AU - Montemagni, Cristiana

AU - Frieri, Tiziana

AU - Birindelli, Nadia

PY - 2014

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N2 - 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.

AB - 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.

KW - Avolition

KW - Disorganization

KW - Engagement with mental health services

KW - Internalized stigma

KW - Neurocognition

KW - Personal resources

KW - Positive symptoms

KW - Real-life functioning

KW - Resilience

KW - Schizophrenia

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