Analisi delle dimensioni psicopatologiche associate alla compromissione del funzionamento sociale in un campione di soggetti con schizofrenia

ntroduction: "Disorganization" was described by Bleuler as a core function in schizophrenia and plays an important role in rehabilitation program. Other dimensions implicated in schizophrenia appear to correlate with impaired social functioning. In a previous study we confirm the hypothesis of an inverse correlation between disorganization and social functioning and a direct relationship between high level of psychopatology and marked reduction of social functioning. The aims of this study were to verify the results of previous studying in a larger number of schizophrenic patients, to confirm the sensitivity of SCADIS in the assess of disorganization and to show other dimensions implicated in social functioning. Methods: We studied a sample of 161 patients with a DSM-IV-TR diagnosis of schizophrenia (118 males and 43 females; paranoid schizophrenia = 72.7%, undifferentiated schizophrenia = 13.7%). The patients were recruited from four clinical centers (FIS, the University of Rome "La Sapienza", the University of Rome "Tor Vergata" and the University of L'Aquila). All subjects gave written consent to take part in the study. A flow-chart was used to collect for all subjects socio-demographic and disease-related data. To assess the dimension of disorganization was used the Scale for the Measurement of Disorganization (SCADIS), to assess the schizophrenic symptomatology was used 3-THREE and Positive And Negative Syndrome Scale (PANSS), and to assess social functioning was used Global Assessment of Functioning scale (GAF). Results: The demographic and clinical characteristics of the study population are outlined in Table I. The mean values of the rating scales were outlined in Table II. The correlation between SCADIS scores with PANSS and 3-THREE scores confirmed the sensitivity of this scale in assessing the disorganization dimension. The study showed an inverse correlation between the severity of alteration of Social Functioning (GAF) with items of the SCADIS, the "thought disorder" subcluster of the PANSS and total and subcluster values of the 3-THREE (Table III). The analysis of variance (ANOVA) of PANSS, SCADIS and 3-THREE scores, in our sample, subdivided into three groups with respect to social functioning (Figs. 1, 2, 3). An inverse significative correlation was demonstrated between four isolated factors (disorganization, positive and negative dimensions and depression/anxiety) and GAF values (Fig. 4, Tables VII, VIII). Conclusions: The study confirmed that subjects with the most severe functioning impairments score are an higher value of disorganization and positive and negative dimensions and the sensitivity of SCADIS in assessing the disorganization dimension.