Determinants of different aspects of everyday outcome in schizophrenia: The roles of negative symptoms, cognition, and functional capacity

Martin T. Strassnig, Tenko Raykov, Cedric O'Gorman, Christopher R. Bowie, Samir Sabbag, Dante Durand, Thomas L. Patterson, Amy Pinkham, David L. Penn, Philip D. Harvey

Research output: Contribution to journalArticlepeer-review

123 Scopus citations


Cognition, negative symptoms, and depression are potential predictors of disability in schizophrenia. We present analyses of pooled data from four separate studies (all n > 169; total n = 821) that assessed differential aspects of disability and their potential determinants. We hypothesized that negative symptoms would predict social outcomes, but not vocational functioning or everyday activities and that cognition and functional capacity would predict vocational functioning and everyday activities but not social outcomes. The samples were rated by clinician informants for their everyday functioning in domains of social and vocational outcomes, and everyday activities, examined with assessments of cognition and functional capacity, rated clinically with the Positive and Negative Syndrome Scale (PANSS) and self-reporting depression. We computed a model that tested the hypotheses described above and compared it to a model that predicted that negative symptoms, depression, cognition, and functional capacity had equivalent influences on all aspects of everyday functioning. The former, specific relationship model fit the data adequately and we subsequently confirmed a similar fit within all four samples. Analyses of the relative goodness of fit suggested that this specific model fit the data better than the more general, equivalent influence predictor model. We suggest that treatments aimed at cognition may not affect social functioning as much as other aspects of disability, a finding consistent with earlier research on the treatment of cognitive deficits in schizophrenia, while negative symptoms predicted social functioning. These relationships are central features of schizophrenia and treatment efforts should be aimed accordingly.

Original languageEnglish (US)
Pages (from-to)76-82
Number of pages7
JournalSchizophrenia Research
Issue number1
StatePublished - Jun 1 2015


  • Cognition
  • Functional capacity
  • Negative symptoms
  • Schizophrenia
  • Social functioning

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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