Activities of daily living, social functioning and their determinants in persons with psychotic disorder - 04/03/11

Doi : 10.1016/j.eurpsy.2010.12.005

S. Viertiö ^a,^⁎ , A. Tuulio-Henriksson ^a,^b, J. Perälä ^a, S.I. Saarni ^a, S. Koskinen ^c, M. Sihvonen ^d, J. Lönnqvist ^a, J. Suvisaari ^a
^a National Institute for Health and Welfare Department of Mental Health and Substance Abuse Services, PO Box 30, 00271 Helsinki, Finland
^b Social Insurance Institution, Research Department PO Box 450, 00101 Helsinki, Finland
^c National Institute for Health and Welfare, Welfare and Health Policies, PO Box 30, 00271 Helsinki, Finland
^d Department of General Practice and Primary Health Care, Institute of Clinical Medicine, PO Box 20, 00014 University of Helsinki, Helsinki, Finland

Corresponding author. Tel.: +358 20 610 8784; fax: +358 20 610 7191.

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Abstract

Objective

The determinants of everyday functioning in persons with psychotic disorder have not been widely studied in community dwelling samples. Our aim was to investigate limitations in everyday functioning among subjects with psychotic disorders in a population-based study.

Method

Everyday functioning was assessed in a nationally representative sample of 7112 persons aged 30+ using interviewer observations and self-reports, while verbal fluency and memory were also measured. Diagnostic assessment of DSM-IV psychotic disorders was based on SCID interview and case-note data. Lifetime-ever diagnoses of psychotic disorder were classified into schizophrenia (n=61), other non-affective psychotic disorders (ONAP) (n=79) and affective psychoses (n=45).

Result

Non-affective psychotic disorder was significantly associated with limitations in everyday functioning, as well as with deficits in verbal fluency and memory. Negative symptoms, depression, age, gender, verbal memory deficits, and reduced visual acuity were predictors of limitations in everyday functioning even after controlling for sociodemographic factors and chronic medical conditions, and difficulties in social functioning were also related to expressive speech problems.

Conclusion

Persons with schizophrenia and ONAP have significantly more problems in everyday functioning than the general population. One significant predictor of problems was reduced visual acuity, which at least in some situations could be easily corrected.

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Keywords : Schizophrenia and psychosis, Epidemiology, Quality of care