{"title":"患有精神分裂症且无家可归的女性的认知功能和功能能力","authors":"Jayakumar Menon , Suvarna Jyothi Kantipudi , Aruna Mani , Rajiv Radhakrishnan","doi":"10.1016/j.scog.2024.100338","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Studies of schizophrenia and homelessness are minimal from the Indian subcontinent. Women with schizophrenia and homelessness in India remain a highly vulnerable group and there is no data to date regarding their clinical characteristics. Cognitive impairment in schizophrenia remains a major factor determining outcomes in schizophrenia. We examined the cognitive functioning of women with schizophrenia and homelessness (WSH) and compared it to an age-matched group of women with schizophrenia living with their family (WSF).</div></div><div><h3>Methods</h3><div>36 women with schizophrenia and homelessness, and 32 women with schizophrenia who were living with family were evaluated for psychopathology using Scale for Assessment of Positive Symptoms (SAPS)/ Scale for assessment of negative symptoms (SANS) scales. Cognitive function was assessed using Montreal Cognitive Assessment (MOCA)/Rowland Universal Dementia Scale (RUDAS), and Frontal Assessment Battery (FAB), disability using World Health Organization - Disability assessment Scale (WHO-DAS) and psychosocial factors using a semi-structured proforma. The groups were compared using <em>t</em>-tests and chi-square for continuous and categorical variables respectively.</div></div><div><h3>Results</h3><div>Women with schizophrenia and homelessness were found to have significantly lower cognitive functioning, and much higher disability. Cognition and disability for women with schizophrenia and homelessness differed by 2–3 standard deviations with the mean for women living with family (i.e. z scores). Women with schizophrenia experiencing homelessness (WSH group) exhibited higher literacy levels and previous work experience compared to their counterparts. Those with family support are likely to face reduced pressures to work or earn, which further suggests that premorbid levels of functioning may not be the primary factors influencing the differences observed in cognitive assessments.</div></div><div><h3>Conclusions</h3><div>The study demonstrates significantly higher cognitive dysfunction in women with homelessness and schizophrenia, raising the possibility of much higher cognitive dysfunction being a predictor for homelessness in Indian women with schizophrenia.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100338"},"PeriodicalIF":2.3000,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cognitive functioning and functional ability in women with schizophrenia and homelessness\",\"authors\":\"Jayakumar Menon , Suvarna Jyothi Kantipudi , Aruna Mani , Rajiv Radhakrishnan\",\"doi\":\"10.1016/j.scog.2024.100338\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Studies of schizophrenia and homelessness are minimal from the Indian subcontinent. Women with schizophrenia and homelessness in India remain a highly vulnerable group and there is no data to date regarding their clinical characteristics. Cognitive impairment in schizophrenia remains a major factor determining outcomes in schizophrenia. We examined the cognitive functioning of women with schizophrenia and homelessness (WSH) and compared it to an age-matched group of women with schizophrenia living with their family (WSF).</div></div><div><h3>Methods</h3><div>36 women with schizophrenia and homelessness, and 32 women with schizophrenia who were living with family were evaluated for psychopathology using Scale for Assessment of Positive Symptoms (SAPS)/ Scale for assessment of negative symptoms (SANS) scales. Cognitive function was assessed using Montreal Cognitive Assessment (MOCA)/Rowland Universal Dementia Scale (RUDAS), and Frontal Assessment Battery (FAB), disability using World Health Organization - Disability assessment Scale (WHO-DAS) and psychosocial factors using a semi-structured proforma. The groups were compared using <em>t</em>-tests and chi-square for continuous and categorical variables respectively.</div></div><div><h3>Results</h3><div>Women with schizophrenia and homelessness were found to have significantly lower cognitive functioning, and much higher disability. Cognition and disability for women with schizophrenia and homelessness differed by 2–3 standard deviations with the mean for women living with family (i.e. z scores). Women with schizophrenia experiencing homelessness (WSH group) exhibited higher literacy levels and previous work experience compared to their counterparts. Those with family support are likely to face reduced pressures to work or earn, which further suggests that premorbid levels of functioning may not be the primary factors influencing the differences observed in cognitive assessments.</div></div><div><h3>Conclusions</h3><div>The study demonstrates significantly higher cognitive dysfunction in women with homelessness and schizophrenia, raising the possibility of much higher cognitive dysfunction being a predictor for homelessness in Indian women with schizophrenia.</div></div>\",\"PeriodicalId\":38119,\"journal\":{\"name\":\"Schizophrenia Research-Cognition\",\"volume\":\"39 \",\"pages\":\"Article 100338\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-11-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Schizophrenia Research-Cognition\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2215001324000398\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Schizophrenia Research-Cognition","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2215001324000398","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
背景印度次大陆对精神分裂症和无家可归问题的研究极少。在印度，患有精神分裂症且无家可归的女性仍然是一个极易受到伤害的群体，迄今为止还没有关于她们临床特征的数据。精神分裂症患者的认知功能障碍仍然是决定精神分裂症治疗效果的主要因素。我们研究了患有精神分裂症且无家可归的女性（WSH）的认知功能，并将其与年龄匹配的与家人同住的精神分裂症女性（WSF）进行了比较。认知功能评估采用蒙特利尔认知评估量表（MOCA）/罗兰老年痴呆通用量表（RUDAS）和额叶评估电池（FAB），残疾评估采用世界卫生组织残疾评估量表（WHO-DAS），社会心理因素评估采用半结构化问卷。结果发现，患有精神分裂症且无家可归的妇女的认知功能明显较低，残疾程度也高得多。患有精神分裂症且无家可归的女性的认知能力和残疾程度与与家人生活在一起的女性的平均值相差 2-3 个标准差（即 z 分数）。与同龄人相比，无家可归的精神分裂症女性患者（WSH 组）具有更高的文化水平和工作经验。有家庭支持的妇女面临的工作或收入压力可能会减少，这进一步表明，病前的功能水平可能不是影响认知评估差异的主要因素。
Cognitive functioning and functional ability in women with schizophrenia and homelessness
Background
Studies of schizophrenia and homelessness are minimal from the Indian subcontinent. Women with schizophrenia and homelessness in India remain a highly vulnerable group and there is no data to date regarding their clinical characteristics. Cognitive impairment in schizophrenia remains a major factor determining outcomes in schizophrenia. We examined the cognitive functioning of women with schizophrenia and homelessness (WSH) and compared it to an age-matched group of women with schizophrenia living with their family (WSF).
Methods
36 women with schizophrenia and homelessness, and 32 women with schizophrenia who were living with family were evaluated for psychopathology using Scale for Assessment of Positive Symptoms (SAPS)/ Scale for assessment of negative symptoms (SANS) scales. Cognitive function was assessed using Montreal Cognitive Assessment (MOCA)/Rowland Universal Dementia Scale (RUDAS), and Frontal Assessment Battery (FAB), disability using World Health Organization - Disability assessment Scale (WHO-DAS) and psychosocial factors using a semi-structured proforma. The groups were compared using t-tests and chi-square for continuous and categorical variables respectively.
Results
Women with schizophrenia and homelessness were found to have significantly lower cognitive functioning, and much higher disability. Cognition and disability for women with schizophrenia and homelessness differed by 2–3 standard deviations with the mean for women living with family (i.e. z scores). Women with schizophrenia experiencing homelessness (WSH group) exhibited higher literacy levels and previous work experience compared to their counterparts. Those with family support are likely to face reduced pressures to work or earn, which further suggests that premorbid levels of functioning may not be the primary factors influencing the differences observed in cognitive assessments.
Conclusions
The study demonstrates significantly higher cognitive dysfunction in women with homelessness and schizophrenia, raising the possibility of much higher cognitive dysfunction being a predictor for homelessness in Indian women with schizophrenia.
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