Impact of Negative and Depressive Symptoms on the Social Functioning in Patients with Schizophrenia During Day ‐ Care Treatment

Aim: Individuals with schizophrenia experience a wide range of difficulty in social functioning. The aim of the study is to examine changes in the subjective and clinician-rated levels of social functioning, social skills, and assertiveness in patients treated in the psychiatric day-care centre. The secondary aim is to test which symptom domains predict better functioning at follow-up. Subjects and Methods: The sample consisted of 32 patients with schizophrenia spectrum disorders who received at least one month of treatment in the day-care centre. Treatment consisted of complex therapeutic program spanning from the psychopharmacological treatment to psychosocial rehabilitation. Subjective social functioning was measured by the Specific Levels of Functioning Scale (SLOF), and objective functioning was measured by the Personal and Social Performance Scale (PSPS). Psychopathology was evaluated by the Clinical Global Impression – Schizophrenia. Additionally, communication skills and assertiveness were measured by self-report measures. Results: We found a significant improvement in the subjective and objective levels of social functioning. Patients also showed improvement in assertiveness. Results of our analysis showed moderate to strong relationships between depressive and negative symptoms and levels of social functioning at follow-up. Less severe positive symptom levels at baseline predicted better functioning at follow-up. Contrary to our expectations, assertiveness was not related to social functioning. Conclusion: The short complex program led to improvement in objective and subjective functioning. Depressive and negative symptoms showed the strongest links to functioning, warranting the need for specialized and tailored interventions focusing on these symptom domains.