Mental Disability in Schizophrenia and its Psychopathological Correlates: A Hospital-Based Cross-sectional Study

Abstract

Background: Schizophrenia is a chronic mental disorder with a relapsing course with generally incomplete remissions and functional decline with varying positive and negative symptoms along with cognitive impairments. Despite the widespread availability of medications to suppress psychosis and prevent relapse, schizophrenia patients continue to remain disabled in different functional aspects in the community. Disability can hence be termed as one of the consequences of schizophrenia. Aims: The aim of this study was to evaluate the frequency of mental disability among patients with schizophrenia and to evaluate the association between clinical features and disabilities among them. Methods: Fifty-three patients who came to psychiatry outpatients in a government tertiary health care hospital who fulfill diagnostic criteria for schizophrenia with at least 2 years of duration of illness and have been on pharmacotherapy for at least 8 weeks before the day of assessment were considered into the study after obtaining an informed consent. The Mini-international neuropsychiatric interview screening for psychiatric diagnosis was applied. The Positive and Negative Syndrome Scale was applied to know the illness severity of schizophrenia. The Indian Disability Evaluation and Assessment Scale is applied to all to assess the disability among the participants. The Clinician Rating Scale is applied to determine the treatment compliance with psychiatric medications. The Montreal Cognitive Assessment Scale (MoCA) was applied to all participants to assess their cognitive functioning. Results: Mild disability was more prevalent followed by moderate and severe disability. The percentage of disability was found to be positively correlated with negative (r = 0.73) and general psychopathology symptoms (r = 0.67) than with positive symptoms (r = 0.39) and was found to be negatively correlated with total MoCA scores (r = −0.5). All these associations were significant. Conclusions: Disability is found to increase with increase in positive, negative, and general psychopathology symptoms and declining cognitive function. Out of all the symptoms, the negative symptoms are found to strongly influence the severity of disability.