Daily activities in people with schizophrenia : relationships with cognition and community functioning

While most people with schizophrenia face the functional consequences of a lifelong disorder, very few studies have investigated the specific domain of daily living activities performance. The purpose of this thesis was to examine the relationships between daily activity performance, cognitive deficits, and community functioning in people with schizophrenia. More specifically, the objectives were: 1) to describe functional limitations during daily task performance, 2) to explore the existence of subgroups of participants with similar functional limitations profiles, 3) to explore the relationships between daily task performance and cognitive functions as well as 4) with community functioning. This thesis tested the hypothesis that limitations in task performance negatively influence community functioning.A sample of 82 individuals with schizophrenia and 28 healthy controls participated in this study and were assessed during a meal preparation task with the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis and on cognitive tests of visuospatial memory, spatial working memory, visuomotor coordination, planning and selective attention. Community functioning was assessed with the Independent living Skills Survey and the Multnomah Community Ability Scale. Limitations in the Perceive, Recall and Plan quadrants of the PRPP System, were found in participants with schizophrenia when compared to a control group (n = 28), as well as in the complete sample (n = 82). Participants in the high-efficiency subgroup ( n =36) were more independent in daily living and performed better on the visuospatial associative learning task than the low-efficiency subgroup (n = 46). At the specific level of individual profiles, participants were distributed along a continuum of low- to high-functioning on the PRPP System factors and on functional, cognitive, and clinical characteristics.The associative learning task was most associated with task performance, along with working memory and planning. Finally, less efficient planning skills were associated with a lower level of community functioning, confirming the hypothesis. These results emphasize the relationship of associative visual memory to daily task performance, as well as that of efficiency in daily activities for residential status. Integrating these findings into the rehabilitation process will contribute to better meeting the needs of people with schizophrenia