Disorganized symptoms predicted worse functioning outcome in schizophrenia patients with established illness

anon79999497 · March 2, 2015, 5:44am

ncbi.nlm.nih.gov

Disorganized Symptoms Predicted Worse Functioning Outcome in Schizophrenia Patients with Established Illness.

BB Ortiz, A Gadelha, CH Higuchi, C Noto, D Medeiros, JCDN Pitta, GM de Araújo Filho, JEC Hallak and RA Bressan, Clinical schizophrenia & related psychoses, Fall 2017

Most patients with schizophrenia will have subsequent relapses of the disorder, with continuous impairments in functioning. However, evidence is lacking on how symptoms influence functioning at different phases of the disease. This study aims to investigate the relationship between symptom dimensions and functioning at different phases: acute exacerbation, nonremission and remission.Patients with schizophrenia were grouped into acutely ill (n=89), not remitted (n=89), and remitted (n=69). Three exploratory stepwise linear regression analyses were performed for each phase of schizophrenia, in which the five PANSS factors and demographic variables were entered as the independent variables and the total Global Assessment of Functioning Scale (GAF) score was entered as the dependent variable. An additional exploratory stepwise logistic regression analysis was performed to predict subsequent remission at discharge in the inpatient population.The Disorganized factor was the most significant predictor for acutely ill patients (p<0.001), while the Hostility factor was the most significant for not-remitted patients and the Negative factor was the most significant for remitted patients (p=0.001 and p<0.001, respectively). In the logistic regression, the Disorganized factor score presented a significant negative association with remission (p=0.007).Higher disorganization symptoms showed the greatest impact in functioning at acute phase, and prevented patients from achieving remission, suggesting it may be a marker of symptom severity and worse outcome in schizophrenia.

Gtx1990 · March 2, 2015, 6:12am

I think I was diagnosed with this kind of sz but now I just say I have schizophrenia and not caterories it as schizophrenia in the new dsm doesn’t subcategories it…yes it has the worst prognosis of all three subcategories of sz

darkside · October 25, 2015, 8:15pm

Ι like your profile photo!!The sisyphus myth!!Very close to what we get through!!

Tomasina · October 26, 2015, 8:26am

Does this mean that now there is no such thing as schizoaffective disorder? Just schizophrenia?

Gtx1990 · October 26, 2015, 9:12am

Schizophrenia subtypes have been dumped in the DSM-5 because of their “limited diagnostic stability, low reliability, and poor validity,” according to the APA. (The old DSM-IV had specified the following schizophrenia subtypes: paranoid, disorganized, catatonic, undifferentiated, and residual type.)

The APA also justified the removal of schizophrenia subtypes from the DSM-5 because they didn’t appear to help with providing better targeted treatment, or predicting treatment response.

The APA proposes that clinicians instead use a “dimensional approach to rating severity for the core symptoms of schizophrenia is included in Section III to capture the important heterogeneity in symptom type and severity expressed across individuals with psychotic disorders.” Section III is the new section in the DSM-5 that includes assessments, as well as diagnoses needing further research.

anon9798425 · October 26, 2015, 9:48am

Sza is still a diagnosis in the DSM, but it is a somewhat controversial one.