COGNITIVE DETERMINANTS OF REAL WORLD SOCIAL FUNCTIONING IN FIRST EPISODE SCHIZOPHRENIA

Abstract

Vimal Doshi Veerappan1, Devaraja Sivalingam2, Preeti Kandaswamy3, Madras Sundararajan Jagadeesan4, Shanthi Nambi5

BACKGROUND Cognitive disturbances in schizophrenia is well characterized and is believed to be the core feature in determining the long term social, vocational and community functioning. The aim and objective of the current study is to compare the cognitive functioning of a sample of patients experiencing their first episode of schizophrenia with that of normal controls. MATERIALS AND METHODS Consecutive patients attending outpatient services of department of psychiatry in a tertiary care post graduate teaching hospital were screened for study inclusion. Based on the selection criterion, thirty-four patients who were experiencing their first episode of schizophrenia and 30 normal age, gender and education matched controls from the community were included in the study. Mini-plus, structured diagnostic instrument was used to diagnose Schizophrenia and The Positive and Negative Syndrome Scale for schizophrenia was utilized to measure psychopathology. Semi-structured questionnaire was used for occupational functioning, duration of untreated illness and sociodemographic indices. Specific cognitive tests measuring speed of processing, vigilance, working memory, executive functioning, new learning ability were used for assessment. Real world social functioning was assessed through social functioning index. RESULTS There were significant differences between the 2 groups in terms of cognitive functioning. Cases showed consistently poorer performance in all domains. Social functioning was related to specific cognitive indices and negative symptoms. CONCLUSION Working-memory (visual), set shifting and new learning ability (visual) significantly correlated with social functioning after controlling for education. Targeted interventions focusing visual memory and mental flexibility may be beneficial in improving social functioning in schizophrenic illness.

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