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Predictors of Community Functioning in Schizophrenia and Substance Use Disorder Patients

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Abstract

Community functioning is a broad term that encompasses various ‘real world’ measures of disability among schizophrenia patients. It includes outcomes such as independent living, social competence and behavioural problems—all of which are priorities for treatment among schizophrenia patients, mental health care providers, and family members. An important goal for rehabilitation programs is to identify predictors of community functioning which, in turn, could be used as targets for intervention. The present case–control study examined socio-demographic and substance use disorder (SUD) variables as well as psychiatric, extrapyramidal, and cognitive symptoms as predictors of community functioning in schizophrenia patients with (DD patients; n = 31) and without comorbid SUDs (SCZ patients; n = 31), and non-psychosis substance abusers (SUD patients; n = 39). Psychiatric and extrapyramidal symptoms were evaluated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia and the Extrapyramidal Symptoms Rating Scale. Cognition was evaluated using the Cambridge Neuropsychological Test Automated Battery (speed of processing, explicit and working memory). In SCZ patients, community functioning was predicted by explicit memory performance. In DD patients, community functioning was predicted by substance abuse, depression and speed of processing. In SUD patients, community functioning was predicted by substance abuse, positive symptoms and education. Our results suggest that cognition should be among the top treatment priorities in SCZ patients, whereas the key treatment targets in DD patients should be substance abuse and depression. Future studies will need to replicate the current findings, using prospective research designs.

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Acknowledgments

This study was funded by an academic partnership between AstraZeneca Pharmaceuticals and the Louis-H Lafontaine Hospital Foundation, and by a Catalyst grant from the Canadian Institute of Health Research. SP is holder of a Junior 1 Young Investigator Award from the Fonds de Recherche en Santé du Québec. ES is holder of the Eli Lilly Chair of schizophrenia from the University of Montreal.

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Authors and Affiliations

  1. Fernand-Seguin Research Centre, Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada

    Simon Zhornitsky, Joelle Desfossés, Tania Pampoulova, Olivier Lipp, Emmanuel Stip & Stéphane Potvin

  2. Occupational Therapy Service, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada

    Ginette Aubin

  3. Clinique du Nouveau-Départ, Montréal, QC, Canada

    Élie Rizkallah, Tania Pampoulova & Jean-Pierre Chiasson

  4. Centre de recherché Fernand-Seguin, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada

    Stéphane Potvin

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  1. Simon Zhornitsky
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  2. Ginette Aubin
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  3. Joelle Desfossés
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  4. Élie Rizkallah
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  8. Emmanuel Stip
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  9. Stéphane Potvin
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Correspondence to Stéphane Potvin.

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Zhornitsky, S., Aubin, G., Desfossés, J. et al. Predictors of Community Functioning in Schizophrenia and Substance Use Disorder Patients. Community Ment Health J 49, 317–322 (2013). https://doi.org/10.1007/s10597-012-9525-y

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  • DOI: https://doi.org/10.1007/s10597-012-9525-y

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