Journal of the International Neuropsychological Society

Research Articles

Psychosocial function in schizophrenia and bipolar disorder: Relationship to neurocognition and clinical symptoms

CARMEN SIMONSENa1a2 c1, KJETIL SUNDETa2, ANJA VASKINNa1, TORILL UELANDa1a3, KRISTIN LIE ROMMa1a3, TONE HELLVINa1a3, INGRID MELLEa1a3, SVEIN FRIISa1a3 and OLE A. ANDREASSENa1a3

a1 Psychosis Research Section, Oslo University Hospital, Oslo, Norway

a2 Department of Psychology, University of Oslo, Oslo, Norway

a3 Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Abstract

In line with a dimensional approach to psychopathology, we examined whether psychosocial function and its relationship to neurocognition and clinical symptoms differ across schizophrenia and bipolar disorder subgroups with and without a history of affective or psychotic episodes. From the TOP study, a heterogeneous sample of individuals with schizophrenia spectrum disorders without (n = 60) and with a history of affective episodes (n = 54); individuals with bipolar spectrum disorders with (n = 64) and without a history of psychosis (n = 56) and healthy controls (n = 268) participated. Psychosocial functioning was measured with the Social Functioning Scale (self-rated) and the Global Assessment of Functioning Scale (clinician-rated), neurocognition with a comprehensive neuropsychological test battery, and symptoms with Inventory of Depressive Symptomatology, Young Mania Rating Scale, and Positive and Negative Syndrome Scale. Clinician-rated functioning was poorer in schizophrenia groups than in bipolar groups, but self-rated functioning was similar across all clinical groups and poorer than in controls. Neurocognition and current clinical symptoms were associated with psychosocial function in bivariate analyses, but current symptoms had a greater independent contribution to functioning than neurocognition across clinical groups in multivariate analyses. Despite differences in neurocognition and psychosocial function, groups showed the same pattern in prediction of functioning irrespective of DSM-IV or clinical definition. (JINS, 2010, 16, 771–783.)

(Received January 07 2010)

(Reviewed April 24 2010)

(Accepted April 27 2010)

Correspondence:

c1 Correspondence and reprint requests to: Carmen Simonsen, Psychosis Research Section - TOP, Building 49, Oslo University Hospital, Kirkeveien 166, 0407 Oslo, Norway. E-mail: c.e.simonsen@medisin.uio.no