V.SEET1, E.ABDIN1, J.H.LAU1, S.C.TAN1, A.JEYAGURUNATHAN1, S.A.CHONG1, M.SUBRAMANIAM1
Institute of Mental Health1
Functional impairment is common in psychiatric disorders, and may be linked to symptom severity. This study examined functional impairment differences among patients with depression, anxiety and schizophrenia spectrum disorders, associations between symptom severity and impairment, and sociodemographic factors associated with impairment in these disorders.
Psychiatric patients (n=375) were recruited from the Institute of Mental Health. Functional impairment was measured using the Sheehan Disability Scale (SDS). Symptom severity was measured with the Patient Health Questionnaire-8 for depression, the Generalised Anxiety Disorder-7 questionnaire for anxiety, and the Positive and Negative Symptoms Scale for schizophrenia spectrum disorders. Analysis of variance was conducted to examine mean differences in SDS scores across the three diagnostic groups. Associations of functional impairment with symptom severity, age, gender, ethnicity, employment and marital status, and education level were examined using linear regression.
Patients with schizophrenia spectrum disorders had significantly lower SDS scores in all three domains (work, social, and family life) than those with depression or anxiety. For schizophrenia spectrum disorders, only general psychopathology had a positive significant relationship with impairment; for depression and anxiety disorder, impairment increased with greater symptom severity. After controlling for symptom severity, among patients with depression or anxiety disorder, those who were older and employed had lower impairment, compared to their younger, unemployed counterparts.
The results highlight the importance of addressing functioning and not just symptom management in treatment programmes to yield better outcomes for patients with psychiatric illness, and reflect a need to tailor treatment programmes to better suit their functional needs.