A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis

Objective Resilience is a multi-dimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last years it has been considered as a personal resource in psychosis and schizophrenia. This study aims to assess the relationship between intra and inter-personal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness. Methods In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of Schizophrenia Spectrum Disorder (DSM-5); age between 18 and 65; written informed consent; to be clinically stable (CGI < 3); history of illness ≥ 5 years; to be compliant with antipsychotic therapy over the last year; regular submission to periodic monthly psychiatric visits. Patients have been evaluated through the following scales: RSA for resilience; BPRS-A, SANS and SAPS for psychotic symptomatology; LSP for psychosocial functioning. Statistical analysis was performed by SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and sub-scores and BPRS-A, SANS, SAPS and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology and psychosocial functioning. Results A statistically significant negative correlation among intra-personal resilience factors and BPRS-A total score emerged, predicting psychiatric symptoms severity and explaining about the 31% of the BPRS-A variance; otherwise, only the inter-personal resilience factors associated with social support was statistically and positively correlated with LSP total score, predicting psychosocial functioning and explaining the 11% of LSP variance. Conclusion The specific contribution that resilience factors may have in predicting the severity of symptoms and the extent of psychosocial functioning emphasizes the importance to personalize the treatment for patients affected by schizophrenia, to promote personal resources and to translate them into better outcomes.