WHODAS 2.0으로 평가한 만성 조현병 환자의 기능 장애와 관련 요인
Functional Disabilities Evaluated using World Health Organization Disability Assessment Schedule 2.0 in Patients with Chronic Schizophrenia and Its Related Factors
1
조회
0
다운로드
6
인용
0
참고문헌
초록
Objectives This study examined the functional disabilities of patients with chronic schizophrenia using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and its related factors. Methods The subjects consisted of 86 patients with schizophrenia with more than 10 years’ duration of illness and 40 healthy volunteers. The functional disabilities and psychopathology were evaluated using the WHODAS 2.0 and 18-items Brief Psychiatric Rating Scale (BPRS-18), respectively. This study analyzed the six sub-domains (‘cognition’, ‘mobility’, ‘self-care’, ‘getting along’, ‘life activities’, and ‘participation’) of WHODAS 2.0 and the four sub-scales (‘positive symptoms’, ‘negative symptoms’, ‘affect’, and ‘resistance’) of BPRS-18. Results Patients with chronic schizophrenia experienced severe functional disabilities across all six sub-domains of WHODAS 2.0 compared to healthy people. Hierarchical regression showed that ‘negative symptoms’ explained the disabilities in the WHODAS 2.0 sub-domains of ‘cognition’ (p<0.05), ‘self-care’ (p<0.05), ‘getting along’ (p<0.01), and ‘life activities’ (p<0.05). ‘Positive symptoms’ and ‘affect’ explained the disabilities in ‘cognition’ (p<0.01 and p<0.05, respectively) and ‘participation’ (p<0.05 and p<0.01, respectively). ‘Resistance’ was found to be a predictor of ‘getting along’ disabilities (p<0.01). Conclusion Negative symptoms mainly accounted for the multiple domains of functional disabilities in the WHODAS 2.0 but residual positive and affective symptoms could also deteriorate the cognition and social participation of patients with chronic schizophrenia.
Abstract
Objectives This study examined the functional disabilities of patients with chronic schizophrenia using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and its related factors. Methods The subjects consisted of 86 patients with schizophrenia with more than 10 years’ duration of illness and 40 healthy volunteers. The functional disabilities and psychopathology were evaluated using the WHODAS 2.0 and 18-items Brief Psychiatric Rating Scale (BPRS-18), respectively. This study analyzed the six sub-domains (‘cognition’, ‘mobility’, ‘self-care’, ‘getting along’, ‘life activities’, and ‘participation’) of WHODAS 2.0 and the four sub-scales (‘positive symptoms’, ‘negative symptoms’, ‘affect’, and ‘resistance’) of BPRS-18. Results Patients with chronic schizophrenia experienced severe functional disabilities across all six sub-domains of WHODAS 2.0 compared to healthy people. Hierarchical regression showed that ‘negative symptoms’ explained the disabilities in the WHODAS 2.0 sub-domains of ‘cognition’ (p<0.05), ‘self-care’ (p<0.05), ‘getting along’ (p<0.01), and ‘life activities’ (p<0.05). ‘Positive symptoms’ and ‘affect’ explained the disabilities in ‘cognition’ (p<0.01 and p<0.05, respectively) and ‘participation’ (p<0.05 and p<0.01, respectively). ‘Resistance’ was found to be a predictor of ‘getting along’ disabilities (p<0.01). Conclusion Negative symptoms mainly accounted for the multiple domains of functional disabilities in the WHODAS 2.0 but residual positive and affective symptoms could also deteriorate the cognition and social participation of patients with chronic schizophrenia.
참고문헌 (27)
- Carpenter WT Jr, "The prediction of outcome in schizophrenia. IV: eleven-year follow-up of the Washington IPSS cohort", J Nerv Ment Dis, 179, pp.517~525 (1991)
- An der Heiden W, "Investigating the long-term course of schizophrenia by sequence analysis", Psychiatry Res, 228, pp.551~559 (2015)
- Hong JP, "Course and outcome of schizophrenia", Korean J Psychopathol, 8, pp.140~150 (1999)
- Cancro R, "Prevention of disability and stigma related to schizophrenia : a review", Schizophrenia, 2, pp.243~310 (1999)
- Knapp M, "WPA Series in Evidence-Based Psychiatry: Schizophrenia", pp.413~460 (2002), Wiley
- Norman RM, "The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale", Acta Psychiatr Scand, 102, pp.303~309 (2000)
- Ritsner MS, "Quality of life impairment in schizophrenia, mood and anxiety disorders", pp.159~226 (2007), Springer
- Veltro F, "Burden on key relatives of patients with schizophrenia vs neurotic disorders : a pilot study", Soc Psychiatry Psychiatr Epidemiol, 29, pp.66~70 (1994)
- Breier A, "National Institute of Mental Health longitudinal study of chronic schizophrenia : prognosis and predictors of outcome", Arch Gen Psychiatry, 48, pp.239~246 (1991)
- Bechi M, "Exploring functioning in schizophrenia : predictors of functional capacity and real-world behaviour", Psychiatry Res, 251, pp.118~124 (2017)
- Bowie CR, "Prediction of real-world functional disability in chronic mental disorders : a comparison of schizophrenia and bipolar disorder", Am J Psychiatry, 167, pp.1116~1124 (2010)
- 지수혁, "조현병 환자의 개인적, 사회적 기능상태의 예측인자", 대한조현병학회지, 19(2), pp.47~59 (2016), 대한조현병학회
- Shamsi S, "Cognitive and symptomatic predictors of functional disability in schizophrenia", Schizophr Res, 126, pp.257~264 (2011)
- Siegel SJ, "Prognostic variables at intake and long-term level of function in schizophrenia", Am J Psychiatry, 163, pp.433~441 (2006)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders (DSM-5®)" (2013), American Psychiatric Association
- Jones SH, "A brief mental health outcome scale-reliability and validity of the global assessment of functioning(GAF)", Br J Psychiatry, 166, pp.654~659 (1995)
- Leon AC, "Assessing psychiatric impairment in primary care with the Sheehan Disability Scale", Int J Psychiatry Med, 27, pp.93~105 (1997)
- Gold LH, "DSM-5 and the assessment of functioning: the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)", J Am Acad Psychiatry Law, 42, pp.173~181 (2014)
- Sheehan DV, "The Mini-International Neuropsychiatric Interview (M.I.N.I.):the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10", J Clin Psychiatry, 59(Suppl 20), pp.22~33 (1998)
- Yoo SW, "Validity of Korean version of the mini-international neuropsychiatric interview", Anxiety and Mood, 2, pp.50~55 (2006)
- Üstün TB, "Developing the World Health Organization Disability Assessment Schedule 2.0", Bull World Health Organ, 88, pp.815~823 (2010)
- Üstün TB, "Measuring health and disability: Manual for WHO disability assessment schedule (WHODAS 2.0)" (2010), World Health Organization
- 윤진상, "지역사회거주 노인에서 한국어판 세계보건기구 장애평가조사표의 개발", 신경정신의학, 43(1), pp.86~92 (2004), 대한신경정신의학회
- Overall JE, "The Brief Psychiatric Rating Scale(BPRS) : recent developments in ascertainment and scaling", Psychopharmacol Bull, 24, pp.97~98 (1988)
- Shafer A, "Meta-analysis of the brief psychiatric rating scale factor structure", Psychol Assess, 17, pp.324~335 (2005)
- 김민경, "Brief Psychiatric Rating Scale - 평정방법에 따른 평정자간 신뢰도와 자기보고식 검사와의 상관연구", Korean Journal of Clinical Psychology, 22(3), pp.685~698 (2003), 한국임상심리학회
- Gould F, "The influence of demographic factors on functional capacity and everyday functional outcomes in schizophrenia", J Clin Exp Neuropsychol, 34, pp.467~475 (2012)