Impact of clinical symptoms on the disability of patients with schizophrenia (Bulgaria, 2018-2019)

Abstract Background According to Global Burden of Disease Studies (1990-2017), schizophrenia causes globally 1.1% of DALYs (disability-adjusted life years) and 2.8% of YLDs (years lived with disability). It is the 8th leading cause of DALYs in 15-44 years of age (WHR 2001). The aim of the study was to assess the impact of clinical symptoms on disability in hospitalised patients with paranoid schizophrenia (PS). Methods The study includes 108 patients treated in Psychiatric Clinic of Pleven University Hospital: 66 males and 42 females, mean age 38.9±10.0, duration of disease 12.8±8.2 years; mean onset of disease at 24 years (Me = 25 and Mo = 22). The research protocol was approved by University Ethical Committee. The disease burden was assessed by Positive and Negative Syndrome Scale (Ð ANSS), and level of disability - by 36-item self-administered WHO Disability Assessment Schedule 2.0. Pierson's r. was used for the relationship between both variables. Data processing was performed by IBM SPSS v.24. Results The average burden of disease based on Ð ANSS was 71,8±5,1. The increase of symptoms' burden leads to worsening in “participation in society” (r = 0.561), “life activities-household” (r = 0.554), “getting along with people” (r = 0.539). Positive symptoms correlate higher with “getting along with people” (r = 0.549), “life activities-household” (r = 0.578), “participation in society” (r = 0.623), and negative symptoms - with “participation in society” (r = 0.526) and “life activities-household” (r = 0.476). Symptoms of disorganisation have highest impact on “life activities-household” (r = 0.807),”getting along with people”(r = 0.556), and “participation in society” (r = 0.649. All correlations were significant at p = 0.0001. “Getting around” has no relation with disease burden. Conclusions Disorganisation symptoms and negative symptoms strongly affect the overall psychosocial functioning, while positive symptoms have less impact on it. Key messages Appropriate treatment schemes directed to negative symptoms would contribute to decrease of disability level in patients with paranoid schizophrenia. Prevention and rehabilitation in PS patients should emphasise promotion of professional and personal development for minimising of disease impact on overall social functioning.