Functionality and factors affecting the functionality on schizophrenic patients who use or not USE clozapine

Title: Functionality and Factors Affecting the Functionality on Schizophrenic Patients Who Use or Not Use Clozapine Objective: Schizophrenia is a mental dissorder which involves thought, perception, affect and social behavior disorders and has negative effects on functioning. Clozapine has been shown to have positive effects on cognitive, interpersonal and occupational functioning, particularly when compared to first-generation antipsychotics. The aim of this study is to compare the functioning of schizophrenia and schizoaffective disorder patients with and without clozapine treatment and to evaluate the effect of clozapine on functioning. Methods: The study is a cross-sectional study. Diagnosed according to SCID-I, 184 schizophrenia (n = 142) and schizoaffective disorder (n = 42) were included in the follow-up and treatment of the psychosis unit of the Adnan Menderes University Research and Treatment Hospital Psychiatric Clinic. Sociodemographic data form, World Health Organization Disability Assessment Scale (WHODAS-II), Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Movement Disorders due to Simpson-Angus Neuroleptics (SAS), Calgary Schizophrenia Depression Scale, Yale-Brown Obsessive Compulsions Scale and Beck Anxiety Scale were examined. Data were analyzed using Statistical Package for Social Science (SPSS) 17.0 program. Descriptive statistics, student t, Mann Whitney U test, Kruskal Wallis, chi-square and Spearman correlation analysis were performed. Statistically significant analyzes were evaluated by multiple linear regression analysis. Type 1 error level α = 0.05 was considered. Results: 47.3% (n = 87) of the patients were using clozapine, while 52.7% (n = 97) were using other antipsychotics. 71.2% of the patients did not have another psychiatric disorder while 20.6% had depression, 14.1% had Obsessive Compulsive Disorder, 6.5% had panic disorder, 3.8% were with by Generalized Anxiety Disorder . PANSS positive, negative, and total scores in patients who used clozapine, they were significantly lower than patients who did not use. Anxiety disorder, depression diagnosis rates; Beck Anxiety and Calgary depression scores did not differ between patients who used clozapine and who didn't. Patients who used clozapine had a higher score on the SAS scale than patients who did not use. Clozapine-treated patients had a higher frequency of OCD diagnosis and higher Yale Brown scale scores than counterparts. The WHOAS 2.0 scale's cognition, mobility, self-care, getting along, life activities, participation in society domains and total scores were lower of patients using clozapine than who didn't. Keep in training and higher education level had a positive effect on functioning; while gender, marital status, alcohol use, and having OCD had no effect. Older age and higher antipsychotic drug doses, higher scores of SAS, PANSS, Beck anxiety and Calgary depression scales were related to worse functional levels. As the Yale Brown's scale scores increased, the level of functionality in the mobility domain got better. As the result of linear regression analyse Clozapine treatment, schizophrenia symptom levels, and education level were able to estimate WHODAS 2.0 total score at approximately 40 percent. While clozapine use and higher educational level reduced the scale score, the exacerbation of the symptoms increased the scale score. Conclusion: The clozapine treatment on patients with schizophrenia and schizoaffective disorder was found to have a positive effect on the functionallity on each domain. The use of clozapine also positively affects positive and negative symptoms.In addition, higher education level affects functionallity positively, while a severe symptoms reduces functionality. Key words: Schizophrenia, Disability Evaluation, Clozapine