Symptoms and cognition as predictors of community functioning: A prospective analysis

Objective: It has been suggested that level of cognitive functioning as ass essed by formal neurocognitive tests may be as important as, or even more i mportant than, symptoms in predicting level of community functioning for pa tients with schizophrenia. The results of past prospective studies, when ca refully examined, do not consistently support this hypothesis. In the curre nt study, the authors used symptom and neurocognitive data to predict subse quent level of functioning in the community. Method: Neurocognitive and sym ptom data collected as part of an earlier study were used to predict the co mmunity functioning of 50 patients with a diagnosis of schizophrenia. Using the Life Skills Profile, staff of a community mental health program assess ed community functioning while blind to the earlier symptom ratings and neu rocognitive performance. Results: Symptoms were more predictive of communit y functioning than were neurocognitive measures. Disorganization symptoms w ere generally more predictive of community functioning than was either psyc homotor poverty or reality distortion. Conclusions: The results of this stu dy and of previous longitudinal studies suggest the importance of using sym ptom levels after optimal treatment, rather than symptoms during acute epis odes, as predictors of community functioning. They also indicate the need t o evaluate the effects of treatment on disorganization as a separable dimen sion of symptoms.