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Social Dysfunction Found in Adults with Remitted Schizophrenia

Key clinical point: Social dysfunction might be present in most adults with schizophrenia and mood disorders, and also was associated with increased illness severity.

Major finding: Among schizophrenia patients, more of those who were remitted had severe social dysfunction, while severe social dysfunction was less common among remitted patients with mood disorders.

Study details: The data come from 4 studies; one included 765 adults with schizophrenia, three included 2,278; 1,954; and 1,829 adults with mood disorders, respectively.

Disclosures: The study was supported in part by the European Union’s Horizon 2020 research and innovation program and the European Federation of Pharmaceutical Industries and Associations (EFPIA). The Group for the Study of Resistant Depression (GRSD) was supported by Lundbeck. The researchers had no financial conflicts to disclose.

Citation:

Porcelli S et al. Prog Neuropsychopharmacol Biol Psychiatry. 2019.

Commentary:

Being overweight or obese is common among people with schizophrenia due to a variety of biological and social factors. Unfortunately, there are few widely used interventions that can reduce weight gain once it has occurred, and this report underscores the importance of contextual factors in determining whether a program may or may not work in helping people with schizophrenia to lose weight and keep it off. The authors of this report suggested that a successful multi-component program such as STEPWISE requires close monitoring of the consumer’s progress towards lifestyle goals and close integration between those receiving the intervention and staff who are helping to implement the program. A successful program also needs to be able to meet the needs of individuals who may have a variety of cognitive and functional deficits at baseline. Scaling up behavioral interventions for application in the real world (as opposed to a research environment) is difficult, so approaches that target people with serious mental illness almost certainly need to use implementation science elements to increase the likelihood of success.—Martha Sajatovic, MD, Professor of Psychiatry and of Neurology; Willard Brown Chair in Neurological Outcomes Research; Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center; Case Western Reserve University School of Medicine.