Real-life functioning and duration of illness in schizophrenia: A mediation analysis

Patients with schizophrenia (SZ) often experience difficulties and impairment in daily functioning. Various factors influence functional outcomes, such as the duration of illness (DOI), the intensity of symptoms, and cognitive impairments. This study aimed at assessing the total, direct, and indirec...

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Main Authors: C. Brasso, S. Bellino, P. Bozzatello, C. Montemagni, P. Rocca
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S240584402417363X
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author C. Brasso
S. Bellino
P. Bozzatello
C. Montemagni
P. Rocca
author_facet C. Brasso
S. Bellino
P. Bozzatello
C. Montemagni
P. Rocca
author_sort C. Brasso
collection DOAJ
description Patients with schizophrenia (SZ) often experience difficulties and impairment in daily functioning. Various factors influence functional outcomes, such as the duration of illness (DOI), the intensity of symptoms, and cognitive impairments. This study aimed at assessing the total, direct, and indirect contribution of the DOI to three key areas of daily functioning for individuals with stable SZ: life skills, work abilities, and interpersonal relationships.Spearman's partial correlations, adjusted for age, gender, and education, were computed between the DOI, symptoms and cognitive variables, and the three real-life functioning domains. We performed three generalized linear mediation models, one for each selected domain of functioning as the dependent variable. Symptoms and cognitive variables significantly correlated with the DOI and at least one of the functioning domains were included in the mediation models as possible mediators between the DOI and the domain of real-life functioning with which they were correlated. The DOI was the independent variable in all models. Effects were computed in total, direct, indirect, and component-estimated forms. A p-value of < .05 was considered statistically significant.A longer DOI was associated with poorer everyday life and working skills, while no such link was found with interpersonal relationships. The negative effect of the DOI on everyday life and working skills was mediated by disorganization and metacognitive mastery and disorganization alone respectively. Early targeted interventions on disorganization and metacognitive mastery might lead to improvements in the functional outcomes of people living with SZ.
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spelling doaj-art-f992ccc4bb7c412887c42d0c39d6eca82025-01-17T04:50:57ZengElsevierHeliyon2405-84402025-01-01111e41332Real-life functioning and duration of illness in schizophrenia: A mediation analysisC. Brasso0S. Bellino1P. Bozzatello2C. Montemagni3P. Rocca4Departement of Neuroscience “Rita Levi Montalcini”, University of Turin, Italy; Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy; Corresponding author. Dipartimento di Neuroscienze “Rita Levi Montalcini”, Via Cherasco 15, Torino (TO), CAP 10126, Italy.Departement of Neuroscience “Rita Levi Montalcini”, University of Turin, Italy; Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria “Città della Salute e della Scienza di Torino”, Turin, ItalyDepartement of Neuroscience “Rita Levi Montalcini”, University of Turin, Italy; Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria “Città della Salute e della Scienza di Torino”, Turin, ItalyStruttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria “Città della Salute e della Scienza di Torino”, Turin, ItalyDepartement of Neuroscience “Rita Levi Montalcini”, University of Turin, Italy; Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria “Città della Salute e della Scienza di Torino”, Turin, ItalyPatients with schizophrenia (SZ) often experience difficulties and impairment in daily functioning. Various factors influence functional outcomes, such as the duration of illness (DOI), the intensity of symptoms, and cognitive impairments. This study aimed at assessing the total, direct, and indirect contribution of the DOI to three key areas of daily functioning for individuals with stable SZ: life skills, work abilities, and interpersonal relationships.Spearman's partial correlations, adjusted for age, gender, and education, were computed between the DOI, symptoms and cognitive variables, and the three real-life functioning domains. We performed three generalized linear mediation models, one for each selected domain of functioning as the dependent variable. Symptoms and cognitive variables significantly correlated with the DOI and at least one of the functioning domains were included in the mediation models as possible mediators between the DOI and the domain of real-life functioning with which they were correlated. The DOI was the independent variable in all models. Effects were computed in total, direct, indirect, and component-estimated forms. A p-value of < .05 was considered statistically significant.A longer DOI was associated with poorer everyday life and working skills, while no such link was found with interpersonal relationships. The negative effect of the DOI on everyday life and working skills was mediated by disorganization and metacognitive mastery and disorganization alone respectively. Early targeted interventions on disorganization and metacognitive mastery might lead to improvements in the functional outcomes of people living with SZ.http://www.sciencedirect.com/science/article/pii/S240584402417363XMediatorDisorganizationMetacognitionMasteryEveryday life skillsWorking skills
spellingShingle C. Brasso
S. Bellino
P. Bozzatello
C. Montemagni
P. Rocca
Real-life functioning and duration of illness in schizophrenia: A mediation analysis
Heliyon
Mediator
Disorganization
Metacognition
Mastery
Everyday life skills
Working skills
title Real-life functioning and duration of illness in schizophrenia: A mediation analysis
title_full Real-life functioning and duration of illness in schizophrenia: A mediation analysis
title_fullStr Real-life functioning and duration of illness in schizophrenia: A mediation analysis
title_full_unstemmed Real-life functioning and duration of illness in schizophrenia: A mediation analysis
title_short Real-life functioning and duration of illness in schizophrenia: A mediation analysis
title_sort real life functioning and duration of illness in schizophrenia a mediation analysis
topic Mediator
Disorganization
Metacognition
Mastery
Everyday life skills
Working skills
url http://www.sciencedirect.com/science/article/pii/S240584402417363X
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