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Relationship of Cognitive Functioning, Adaptive Life Skills, and Negative Symptom Severity in Poor-Outcome Geriatric Schizophrenia Patients

Received June 14, 1999; revised October 20, 1999; accepted October 26, 1999. From the Department of Psychiatry, Mount Sinai School of Medicine, New York, New York; Department of Psychology, Hofstra University, Hempstead, New York; and Pilgrim Psychiatric Center, Clinical Neuroscience Treatment Unit, West Brentwood, New York. Address correspondence to Dr. McGurk, Pilgrim Psychiatric Center, 998 Crooked Hill Road, Building 81/102, West Brentwood, NY 11717.

The authors assessed whether cognitive functioning and negative symptoms are related to functional outcome across severity of negative symptoms and examined relationships between symptom domains in patients with high versus low negative symptom severity. The interrelationships between cognitive functioning and functional skills in poor-outcome geriatric schizophrenic patients were compared between those who were in the first (n=81) and the fourth quartiles (n=127) of negative symptom severity based on the normative data in the Positive and Negative Syndrome Scale. It was found that negative symptoms and cognitive functioning were the strongest correlates of functional status in geriatric poor-outcome schizophrenic patients—regardless of negative symptom severity. Interestingly, the greater the severity of negative symptoms, the less strongly negative symptoms were related to functional outcome. The present findings demonstrate that the relationship of cognitive functioning to social and adaptive functioning remains significant despite differing levels of negative symptom severity.

Key Words: Schizophrenia • Geriatric Psychiatry • Cognition • Activities of Daily Living

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