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11-11-2009 | Mental health | Article

Quality and nature of social disability similar across affective disorders


Free abstract

MedWire News: The quality and nature of social disability is similar among patients with schizophrenia, schizoaffective disorder, and affective disorders, although the severity differs, study findings suggest.

Deficits in social functioning are common in patients with schizophrenia and other psychiatric disorders and have received increasing attention over the years. However, there has been little investigation of social functioning differences in affective, schizoaffective, and schizophrenia patients over the long term.

Ronald Bottlender, from Newham Centre for Mental Health in London, UK, and colleagues therefore studied 177 patients with lifetime diagnoses belonging to the schizophrenia (61 patients), schizoaffective disorder (58 patients), or affective spectrum (58 patients).

Psychopathological, sociodemographic, and other illness-related variables were assessed using the Association for Methodology and Documentation in Psychiatry system at index hospitalization and at 15-year follow-up, while social disability was determined using the Mannheim Disability Assessment Schedule.

Schizophrenia patients had significantly higher global estimates of social adjustment scores than affective and schizoaffective disorder patients, at scores of 2.72 versus 1.14 and 0.76, respectively. In addition, 64% of schizophrenia patients had severe to very severe levels of disability, compared with just 19% of schizoaffective disorder patients and 5% of affective disorder patients.

However, patients from all three groups showed similar maxima and minima in their profiles of social disability, indicating a similar quality and nature of disability, despite differences in the severity.

The team also reports in the journal Schizophrenia Research that, on multiple logistic regression analysis, severe social disability was best explained by the apathic syndrome, regardless of diagnostic group, with gender and age also having no significant influence.

“Our findings suggest that symptoms and behavioral aspects may be more important for social exclusion processes than just the label of a psychiatric diagnosis,” the researchers say.

“Hence, our findings emphasize the importance of achieving symptom remission as a crucial aspect of the recovery process and preventing social disability by all therapeutic and rehabilitative means.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Liam Davenport

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