The Course of Neuropsychological Performance and Functional Capacity in Older Patients with Schizophrenia: Influences of Previous History of Long-Term Institutional Stay

Philip D Harvey, Abraham Reichenberg, Christopher R. Bowie, Thomas L. Patterson, Robert K. Heaton

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: Chronically institutionalized patients with schizophrenia have been reported to manifest cognitive and functional decline. Previous studies were limited by the fact that current environment could not be separated from lifetime illness course. The present study examined older outpatients who varied in their lifetime history of long-term psychiatric inpatient stay. Methods: Community-dwelling patients with schizophrenia (n = 111) and healthy comparison subjects (n = 76) were followed up to 45 months and examined two or more times with a neuropsychological battery and performance-based measures of everyday living skills (University of California San Diego Performance-Based Skills Assessment Battery [UPSA]) and social competence. A mixed-effects model repeated-measures method was used to examine changes. Results: There was a significant effect of institutional stay on the course of the UPSA. When the schizophrenia patients who completed all three assessments were divided on the basis of length of institutional stay and compared with healthy comparison subjects, patients with longer stays worsened on the UPSA and social competence, while patients with shorter stays improved. For neuropsychological performance, both patient samples worsened slightly, while the healthy comparison group manifested a practice effect. Reliable change index analyses showed that worsening on the UPSA for longer stay patients was definitely nonrandom. Conclusions: Lifetime history of institutional stay was associated with worsening on measures of social and everyday living skills. Neuropsychological performance in schizophrenia did not evidence the practice effect seen in the healthy comparison sample. These data suggest that schizophrenia patients with a history of long institutional stay may worsen even if they are no longer institutionalized.

Original languageEnglish
Pages (from-to)933-939
Number of pages7
JournalBiological Psychiatry
Volume67
Issue number10
DOIs
StatePublished - May 15 2010
Externally publishedYes

Fingerprint

Schizophrenia
Healthy Volunteers
Independent Living
Psychiatry
Inpatients
Length of Stay
Outpatients

Keywords

  • Aging
  • cognition
  • disability
  • schizophrenia

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

The Course of Neuropsychological Performance and Functional Capacity in Older Patients with Schizophrenia : Influences of Previous History of Long-Term Institutional Stay. / Harvey, Philip D; Reichenberg, Abraham; Bowie, Christopher R.; Patterson, Thomas L.; Heaton, Robert K.

In: Biological Psychiatry, Vol. 67, No. 10, 15.05.2010, p. 933-939.

Research output: Contribution to journalArticle

@article{4c30c2f883e0452a8557f171323e762f,
title = "The Course of Neuropsychological Performance and Functional Capacity in Older Patients with Schizophrenia: Influences of Previous History of Long-Term Institutional Stay",
abstract = "Background: Chronically institutionalized patients with schizophrenia have been reported to manifest cognitive and functional decline. Previous studies were limited by the fact that current environment could not be separated from lifetime illness course. The present study examined older outpatients who varied in their lifetime history of long-term psychiatric inpatient stay. Methods: Community-dwelling patients with schizophrenia (n = 111) and healthy comparison subjects (n = 76) were followed up to 45 months and examined two or more times with a neuropsychological battery and performance-based measures of everyday living skills (University of California San Diego Performance-Based Skills Assessment Battery [UPSA]) and social competence. A mixed-effects model repeated-measures method was used to examine changes. Results: There was a significant effect of institutional stay on the course of the UPSA. When the schizophrenia patients who completed all three assessments were divided on the basis of length of institutional stay and compared with healthy comparison subjects, patients with longer stays worsened on the UPSA and social competence, while patients with shorter stays improved. For neuropsychological performance, both patient samples worsened slightly, while the healthy comparison group manifested a practice effect. Reliable change index analyses showed that worsening on the UPSA for longer stay patients was definitely nonrandom. Conclusions: Lifetime history of institutional stay was associated with worsening on measures of social and everyday living skills. Neuropsychological performance in schizophrenia did not evidence the practice effect seen in the healthy comparison sample. These data suggest that schizophrenia patients with a history of long institutional stay may worsen even if they are no longer institutionalized.",
keywords = "Aging, cognition, disability, schizophrenia",
author = "Harvey, {Philip D} and Abraham Reichenberg and Bowie, {Christopher R.} and Patterson, {Thomas L.} and Heaton, {Robert K.}",
year = "2010",
month = "5",
day = "15",
doi = "10.1016/j.biopsych.2010.01.008",
language = "English",
volume = "67",
pages = "933--939",
journal = "Biological Psychiatry",
issn = "0006-3223",
publisher = "Elsevier USA",
number = "10",

}

TY - JOUR

T1 - The Course of Neuropsychological Performance and Functional Capacity in Older Patients with Schizophrenia

T2 - Influences of Previous History of Long-Term Institutional Stay

AU - Harvey, Philip D

AU - Reichenberg, Abraham

AU - Bowie, Christopher R.

AU - Patterson, Thomas L.

AU - Heaton, Robert K.

PY - 2010/5/15

Y1 - 2010/5/15

N2 - Background: Chronically institutionalized patients with schizophrenia have been reported to manifest cognitive and functional decline. Previous studies were limited by the fact that current environment could not be separated from lifetime illness course. The present study examined older outpatients who varied in their lifetime history of long-term psychiatric inpatient stay. Methods: Community-dwelling patients with schizophrenia (n = 111) and healthy comparison subjects (n = 76) were followed up to 45 months and examined two or more times with a neuropsychological battery and performance-based measures of everyday living skills (University of California San Diego Performance-Based Skills Assessment Battery [UPSA]) and social competence. A mixed-effects model repeated-measures method was used to examine changes. Results: There was a significant effect of institutional stay on the course of the UPSA. When the schizophrenia patients who completed all three assessments were divided on the basis of length of institutional stay and compared with healthy comparison subjects, patients with longer stays worsened on the UPSA and social competence, while patients with shorter stays improved. For neuropsychological performance, both patient samples worsened slightly, while the healthy comparison group manifested a practice effect. Reliable change index analyses showed that worsening on the UPSA for longer stay patients was definitely nonrandom. Conclusions: Lifetime history of institutional stay was associated with worsening on measures of social and everyday living skills. Neuropsychological performance in schizophrenia did not evidence the practice effect seen in the healthy comparison sample. These data suggest that schizophrenia patients with a history of long institutional stay may worsen even if they are no longer institutionalized.

AB - Background: Chronically institutionalized patients with schizophrenia have been reported to manifest cognitive and functional decline. Previous studies were limited by the fact that current environment could not be separated from lifetime illness course. The present study examined older outpatients who varied in their lifetime history of long-term psychiatric inpatient stay. Methods: Community-dwelling patients with schizophrenia (n = 111) and healthy comparison subjects (n = 76) were followed up to 45 months and examined two or more times with a neuropsychological battery and performance-based measures of everyday living skills (University of California San Diego Performance-Based Skills Assessment Battery [UPSA]) and social competence. A mixed-effects model repeated-measures method was used to examine changes. Results: There was a significant effect of institutional stay on the course of the UPSA. When the schizophrenia patients who completed all three assessments were divided on the basis of length of institutional stay and compared with healthy comparison subjects, patients with longer stays worsened on the UPSA and social competence, while patients with shorter stays improved. For neuropsychological performance, both patient samples worsened slightly, while the healthy comparison group manifested a practice effect. Reliable change index analyses showed that worsening on the UPSA for longer stay patients was definitely nonrandom. Conclusions: Lifetime history of institutional stay was associated with worsening on measures of social and everyday living skills. Neuropsychological performance in schizophrenia did not evidence the practice effect seen in the healthy comparison sample. These data suggest that schizophrenia patients with a history of long institutional stay may worsen even if they are no longer institutionalized.

KW - Aging

KW - cognition

KW - disability

KW - schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=77951620926&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951620926&partnerID=8YFLogxK

U2 - 10.1016/j.biopsych.2010.01.008

DO - 10.1016/j.biopsych.2010.01.008

M3 - Article

C2 - 20202624

AN - SCOPUS:77951620926

VL - 67

SP - 933

EP - 939

JO - Biological Psychiatry

JF - Biological Psychiatry

SN - 0006-3223

IS - 10

ER -