The relationship of neurocognitive impairment with duration of disease and quality of life in patients with schizophrenia

Objective: Cognitive dysfunction is a fundamental feature of schizophrenia. Cognitive disorders can manifest in varying degrees of severity in various areas, including attention, memory, verbal learning, and executive functions. These disorders begin in the early stages of psychosis and continue throughout the disease in most patients. At the same time, neurocognitive disorders have negative effects on quality of life. There are contradictory opinions in studies evaluating cognitive functions and quality of life in patients with schizophrenia, although there are opinions that the education level, age, and some socio-demographic characteristics of the patients affect neurocognitive functions and quality of life. By shedding light on these data, our study aimed to investigate the relationship of neurocognitive impairment with disease duration, quality of life, and sociodemographic characteristics in patients with schizophrenia. Method: 100 patients diagnosed with schizophrenic disorder receiving outpatient or inpatient treatment in Çukurova University Faculty of Medicine Balcalı Hospital Department of Mental Health and Diseases constitute the sample group of this study. In addition, 80 healthy individuals from the general population who were similar in gender and age were included in the study as a control group in order to compare neurocognitive functions and quality of life values between schizophrenic patients and healthy individuals and to determine the differences. In addition to the socio-demographic data form which is created for the control group, the compatibility correlations of the Frontal Assessment Battery (FAB), World Health Organization Quality of Life (WHOQOL-BREF), and World Health Organization Disability Assessment Chart (WHODAS 2.0) were examined with each other. In addition to the scales listed above, the Positive and Negative Syndrome Scale (PANSS) and Beck Cognitive Insight Scale (BCIS) were applied to the patient group. Results: The difference between the mean FAB score of those who were in the first 5 years of their disease and those who were sick for more than 5 years was found to be statistically significant (p<0.05). There was no significant difference between the mean quality of life score and the year of illness (p >0.05). A significant difference was found between disability, quality of life, and FAB scale mean scores according to the number of hospitalizations (p<0.05). When the patients were examined according to their education level, a significant difference was found between disability, quality of life, and FAB scale mean scores (p<0.05). The difference between the quality of life and FAB scale mean scores of those with and without a family history was significant (p<0.05). FAB's total score was positively and significantly correlated with the total score of educational status and quality of life; it showed a significant negative correlation with a year of illness and PANSS scale scores. There was a significant negative correlation between the total score of disability, educational status, and quality of life in patients; It showed a significant positive correlation with PANSS scale scores. It was found that disability was lower and quality of life was higher in the working patient group compared to the non-working patients. Impairment in frontal lobe functions and executive functions was more common in the non-working group. Conclusion: According to the results of our study in the first five years of the disease, disability and neurocognitive effects were seen less in patients with higher education levels and in employees, and the quality of life was higher in those group. As the number of hospitalizations increased, disability was higher, quality of life was worse, and cognitive functions were more affected. As the duration of illness and PANSS scale scores increased, cognitive dysfunction was found to be higher. The impact on cognitive functions was less in a group with a higher quality of life total score and higher education level. In the first years of the disease, early diagnosis, treatment and rehabilitation, and social support studies should be carried out in order to improve the education life and employment of the patients and to lead a better quality and functional life. Keywords: Schizophrenia, Neurocognitive Functioning, Quality of Life, Disability, Duration of İllness