Open AccessThe interplay among psychopathology, personal resources, context‐related factors and real‐life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and non‐recovered patients
Author(s) -
Galderisi Silvana,
Rucci Paola,
Mucci Armida,
Rossi Alessandro,
Rocca Paola,
Bertolino Alessandro,
Aguglia Eugenio,
Amore Mario,
Bellomo Antonello,
Bozzatello Paola,
Bucci Paola,
Carpiniello Bernardo,
Collantoni Enrico,
Cuomo Alessandro,
Dell'Osso Liliana,
Di Fabio Fabio,
Giannantonio Massimo,
Gibertoni Dino,
Giordano Giulia Maria,
Marchesi Carlo,
Monteleone Palmiero,
Oldani Lucio,
Pompili Maurizio,
Roncone Rita,
Rossi Rodolfo,
Siracusano Alberto,
Vita Antonio,
Zeppegno Patrizia,
Maj Mario
Publication year - 2020
Publication title -
world psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 15.51
H-Index - 93
eISSN - 2051-5545
pISSN - 1723-8617
DOI - 10.1002/wps.20700
Subject(s) - psychopathology , betweenness centrality , context (archaeology) , schizophrenia (object oriented programming) , closeness , psychology , centrality , clinical psychology , psychiatry , biology , paleontology , mathematical analysis , mathematics , combinatorics
Improving real‐life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses previously explored, by using network analysis, the interplay among illness‐related variables, personal resources, context‐related factors and real‐life functioning in a large sample of patients with schizophrenia. The same research network has now completed a 4‐year follow‐up of the original sample. In the present study, we used network analysis to test whether the pattern of relationships among all variables investigated at baseline was similar at follow‐up. In addition, we compared the network structure of patients who were classified as recovered at follow‐up versus those who did not recover. Six hundred eighteen subjects recruited at baseline could be assessed in the follow‐up study. The network structure did not change significantly from baseline to follow‐up, and the overall strength of the connections among variables increased slightly, but not significantly. Functional capacity and everyday life skills had a high betweenness and closeness in the network at follow‐up, as they had at baseline, while psychopathological variables remained more peripheral. The network structure and connectivity of non‐recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other's activation, contributing to poor outcome in schizophrenia. Early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self‐reinforcing networks of symptoms and dysfunctions in people with schizophrenia.