Krystyna Jaracz, Krystyna Górna, Filip Rybakowski
Social functioning in first-episode schizophrenia. A prospective follow-up study 19-27
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Aim: was to compare social functioning of first-admitted schizophrenic patients with healthy controls and evaluate the influence of different variables on social abilities of patients, 1 month (T1), 13 months after hospitalization (T2) and 4-6 years after T1 (T3).
Material and methods: A group of 74 schizophrenic patients: 46 male and 28 female; age 24.7 ± 6.7 and a control group of matched 52 male and 34 female subjects were enrolled. Social Functioning Scale (SFS), Positive and Negative Syndrome Scale (PANSS), Global Assessment Scale (GAS) and socio-demographic questionnaire were used.
Results: In all examinations SFS scores in the patients (T1- 103.5; T2- 104.4; T3- 107.0), were significantly lower than in the healthy controls- 117.0 (p<0.001). In longitudinal analysis, a mild improvement was observed in T3 SFS score and in its three subscales (p<0.05) In cross-sectional analysis, better social functioning was associated with female sex, longer education, activity before admission, and better functioning in the pre-admission period. In regression analyses SFS at T2 was predicted by PANSS total scores at T1 (27% of the variance), and at T3 by PANSS total scores at T1 and duration of psychotic symptoms before the first hospitalization (20% of the variance).
Conclusions: Social functioning in schizophrenia is impaired from the onset of disease and may be mildly improved in intermediate follow-up. Female sex, higher education and pre-admission functioning are correlated with better social outcome, however regression analysis point to the duration of untreated illness and severity of symptoms after the first admission, as important predictors of social functioning in early course of schizophrenia.