The impact of neurocognition and symptom severity on community functioning in psychosis: a transdiagnostic analysis

Jaelin Rippe, BA

McLean Hospital – Research Assistant

Scientific Abstract

Background: Evidence indicates that cognitive performance correlates with community functioning in both schizophrenia (SZ) and bipolar disorder with psychosis (BD). However, whether the effects of symptom severity and cognitive impairment on community functioning differ between SZ and BD is still unclear. Thus, we aimed to examine the relationships between cognition, symptom severity. and community functioning in 74 people with either SZ or BD, and to evaluate the extent to which cognitive and clinical predictors of community functioning differed across diagnoses.

Methods: Demographic, cognitive (MATRICS Consensus Cognitive Battery, MCCB), symptom severity (Positive And Negative Syndrome Scale, PANSS; Young Mania Rating Scale, YMRS; Montgomery–Åsberg Depression Rating Scale, MADRS), and community functioning (Multnomah Community Ability Scale, MCAS) data were collected in 74 patients with psychosis. The associations between cognitive functioning, clinical symptoms, and community functioning were assessed using correlational and stepwise linear regression analyses.

Results: While cognition initially correlated with community functioning in SZ (R2 = .123, F(1, 34) = 4.770, p = .036) but not BD (R2 = .013, F(1, 36) = .475, p = .495), cognition no longer predicted community functioning in either group once symptom severity was accounted for through stepwise linear regression. These regression models run separately by group showed that symptom severity significantly contributed to the model in BD (R2 = .649, F(6, 31) = 9.53, p<.0001) as well as in SZ (R2 = . 519, F(2,32) =17.26, p<.0001) while cognition did not in either group or in the total sample.

Conclusions: Our results indicate that different symptom profiles were predictive of community functioning in SZ and BD. Positive symptoms were predictive of community functioning in SZ only, whereas PANSS general was predictive of community functioning in both SZ and BD and symptoms of mania were predictive of community functioning in BD. This suggests that, even in clinically stable outpatients, residual symptoms have significant and diagnosis-specific effects on community functioning.


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research Areas


Jaelin D. Rippe, BA, Mei-Hua Hall, PhD, Kathryn Eve Lewandowski, PhD

Principal Investigator

Kathryn Eve Lewandowski, PhD