T68. RELATIONSHIP BETWEEN GLOBAL AND COGNITIVE FUNCTIONING IN PATIENTS WITH SCHIZOPHRENIA IN A GENERAL HOSPITAL IN PERU
Authors: Huarcaya Jeff 
Published: May 2020

Background

Schizophrenia is a chronic mental disorder, which produces high costs and has a substantial impact on health care budgets globally. This is mainly due to poor global and cognitive functioning in these patients. The objective of this study was to relate global functioning and cognitive functioning in patients with schizophrenia who attend the outpatient clinic of a general hospital in Peru during the years 2018–2019.

Methods

Non-experimental quantitative study of descriptive cross-sectional correlational type. The sample was for convenience, and consisted of 53 patients with schizophrenia from the “Hospital Nacional de la PNP”. Functioning Assessment Short Test (FAST) was used to assess global functioning, the Screen for Cognitive Impairment (SCIP), cognitive functioning, and a data collection sheets with the history of the disease.

The relationship between FAST and SCIP with the qualitative variables was evaluated by the Mann-Whitney U test or Student’s t test depending on whether they met the normality assumptions. The linear correlation between the FAST, the SCIP and the other quantitative variables was evaluated using Spearman’s Rho.

A multiple linear regression model was constructed in which all variables other than the total FAST result are considered using the forward method.

Results

It was found that 34 (62.2%) were male; 52 (98.1%), single; 39, (73.6%) without a current job. We found worse overall functioning in patients with lower educational level (p = 0.005) and without a current job (p = 0.004). The total FAST was correlated with the time of the disease (ρ = 0.334, p &lt;0.05) and with the number of previous psychotic episodes (ρ = 0.354, p &lt;0.01). We found worse cognitive functioning in patients with lower educational level (p = 0.000) and without a current job (p = 0.017). The SCIP total was correlated to the FAST (ρ = 0.542, p &lt;0.01).

The multiple linear regression analysis with the total FAST score as the explained variable evidenced the existence of a relationship between variables that is explained by the equation:

Y = 57.032 + (-0.521) X1 + (1.896) X2

Where Y is the total FAST score, X1 the total SCIP and X2 the number of previous psychotic episodes. The coefficient of determination was 0.392 and the mean square error of 161.46. The Durbin-Watson statistic was 1,529.

Discussion

This is the first exploratory pilot analysis of the factors associated with global functioning, with special emphasis on cognitive functioning and the history of the disease, in Peruvian patients with schizophrenia.

Patients with higher educational level and those who have a current job showed a better global and cognitive functioning. It was found an indirect and significant relationship of moderate intensity between cognitive functioning and its subtest with global functioning, that is, a lower level of cognitive functioning is related to greater difficulties in the daily functioning of patients with schizophrenia. Both the bivariate analysis and the linear regression model found a relationship between global and cognitive functioning. In the multiple linear regression model, it was found that the total SCIP was the one that had the most influence on global functioning (Beta = -0.528), that is, lower levels of cognitive functioning are related to high levels of poor global functioning.

Taking these results into account, we recommend implementing functional and cognitive evaluation programs in patients with schizophrenia at the “Hospital Nacional de la PNP”. Future longitudinal studies should be performed on samples from larger patients, especially with a first psychotic episode, with the purpose of seeking a cause-effect relationship between global and cognitive functioning in patients with schizophrenia.