A path model on neuropsychiatric symptoms, daily function, memory, and perceived stress in schizophrenic patients in Hong Kong

Abstract

BACKGROUND: The relationships between neuropsychiatric symptoms and daily functioning, memory, and perceived stress are commonly analyzed bivariately and multivariately. The present study aimed to explore interdependencies of clinical determinants on daily functioning and perceived stress in patients with chronic schizophrenia. METHODS: A total of 146 residential schizophrenic patients in a long-term care hostel provided data on psychiatric symptoms, deficits on motor coordination and sequencing, digit spans, daily living functions, and perceived stress via validated questionnaires, psychiatric interview, and assessments. Indirect effects from the psychiatric symptoms to perceived stress via a series of potential mediators were examined using bootstrapping. RESULTS: All of the symptoms showed significant indirect effects on perceived stress via the mediators. Motor deficit and activities of daily living mediated the indirect effects of negative, excitement, and depression symptoms on perceived stress. Sequencing deficit and forward digit span mediated the indirect effects of positive, negative, and cognitive symptoms on perceived stress. The model explained 15.2% of the variance in perceived stress. DISCUSSIONS: This study suggests indirect pathways from psychiatric symptoms to subjective perceived stress in schizophrenic patients via neurological deficits, daily functioning, and memory. Structural equation modeling could be performed in future studies to disentangle and identify a complex model of direct and indirect pathways of clinical determinants on psychological outcomes. LEARNING OBJECTIVES: 1. Identify the potential pathways from psychiatric symptoms to subjective perceived stress 2. Summarize the mediating roles of neurological deficits and digit spans in the model