Improvement of Activities of Daily Living in Eight Schizophrenia Subtypes Based on Six Therapy Methods: A Pilot Study Based on a Hospital Medical Record Analysis

Background: The activities of daily living (ADL) in schizophrenia patients were always a focus of attention. This study aimed to assess the changes of proportions of different schizophrenia subtypes with time in different subgroups and the improvement of ADL of patients with schizophrenia subtypes using different therapy methods and its related factors.

Methods: All the data were extracted from one biggest professional psychiatric hospital in Beijing of China. All the medical records from all the subjects with confirmed schizophrenia diagnosis from 2005 to 2015 in this study. ADL index was evaluated based on the Barthel ADL Questionnaire. Multiple linear regression models were used to explore the influencing factors of the improvement of ADL index.

Results: A total of 12,995 subjects age from 9 to 90 years were included in this study. A bimodal distribution with ages for the overall schizophrenia types and therapeutic methods that there were two peaks of age groups, 20-30 years and 50-60 years, with relatively larger number of cases. It was mainly driven by the unmarried status. Undifferentiated schizophrenia, paranoid schizophrenia and residual schizophrenia accounted for the most causes, but residual schizophrenia was specifically distributed in the high age groups from 50 to 80 years. Electroconvulsive therapy was mainly used in young subjects, but antipsychotic medication therapy and Moritatherapy were mainly used old subjects. Other three therapy methods were evenly used among all age groups. Paranoid schizophrenia and undifferentiated schizophrenia presented statistically significant improvement of ADL index, particularly using the electroconvulsive therapy, followed by group psychotherapy, recreation therapy, behavior modification therapy, Moritatherapy and antipsychotic medication in turn. Patients of males, combining with old ages and unmarried status, tend not to get higher and better improvements of ADL index, particularly for those with nervous schizophrenia, youth schizophrenia, simple schizophrenia and undifferentiated schizophrenia.

Conclusions: An age-specific characteristic existed in the proportions of schizophrenia subtypes therapy methods. The improved quality of life of schizophrenia patients need to be strengthened targeting at the priority population with high risk factors and optimized therapeutic methods.

Keywords: Schizophrenia; Activities of daily living; Therapy methods; China.