Abstract: Service Implications of Symptom Contributors to Quality of Life in Schizophrenia (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)
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203P Service Implications of Symptom Contributors to Quality of Life in Schizophrenia

Schedule:
Friday, January 12, 2024
Marquis BR Salon 6, ML 2 (Marriott Marquis Washington DC)
* noted as presenting author
Samuel Murphy, MSW, Graduate Student, University of Pittsburgh, Pittsburgh, PA
Ana Flores, MSW, Doctoral Student, University of Pittsburgh, Pittsburgh, PA
Nev Jones, PhD, Assistant Professor, University of Pittsburgh, Pittsburgh, PA
Shaun Eack, Professor and Associate Dean for Research, University of Pittsburgh, PA
Matcheri Keshavan, MD, Professor and Academic Head of Psychiatry, Harvard University, MA
Background and Purpose: Individuals with schizophrenia and other associated disorders experience significant distress and disturbance to their quality of life (QOL) due to a multitude of co-occurring symptoms. While the positive symptoms of psychosis are often seen as a primary source of impairment to QOL, individuals experience an array of other symptoms, including cognitive challenges, negative symptoms, and general anxiety and depression. This study sought to examine the impact of diverse symptom constructs on QOL and attempted to infer directionality of influence via network analysis to provide implications for social work intervention development

Methods: Adults with schizophrenia (N = 82), schizoaffective (N = 18), or schizophreniform disorder (N = 2) participating in an 18-month randomized trial of Cognitive Enhancement Therapy (CET) completed assessments of QOL and symptomatology prior to treatment. Field standard measures were used to collect data on positive, negative, and general illness symptomatology, as well as QOL and cognitive abilities. Both exploratory factor analysis and network analysis were implemented to explore associations between QOL and symptom measure constructs, and directed acyclic graphs were constructed to observe any significant associations between symptom domains and QOL.

Results: Factor analysis results indicated that individual measures separated into their respective symptom domains, and strong factor correlations were found between QOL and negative symptoms (r = -.34), as well as QOL and general anxiety/depression symptoms (r = -.42), with the weakest associations with QOL being positive symptoms (r = -.20) and cognition (r = .25). Analysis of network metrics found QOL as the central cluster within the network, with every symptom construct branching off one of the QOL domains. Visualization of the network structure and inclusion of weighted edges illustrate the dense and strong associations between QOL, negative symptomatology, and general anxiety/depression symptoms.

Conclusions and Implications: Symptom constructs such as negative symptoms that most directly impact QOL in stabilized patients need to be targeted more appropriately by psychosocial interventions in addition to pharmacotherapy. Social work and other psychosocial interventions to improve QOL in individuals experiencing psychosis should center around negative symptomatology and general anxiety/depression symptoms to increase effectiveness.

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