Environmental Barriers and Functional Outcomes in Patients with Schizophrenia in Taiwan: The Capacity-Performance Discrepancy

Abstract

Environmental factors are crucial determinants of disability in schizophrenic patients. Using data from the 2014–2018 Certification of Disability and Care Needs dataset, we identified 3882 adult patients (46.78% females; age, 51.01 ± 13.9 years) with schizophrenia. We found that patients with severe schizophrenia had lower capacity and performance than those with moderate schizophrenia. The chances of having an access barrier to environmental chapter 1 (e1) products and technology in moderate schizophrenic patients and in severe schizophrenic patients were 29.5% and 37.8%, respectively. Logistic regression analyses demonstrated that the performance score was related to accessibility barriers in the categories described in e1, with adequate fitness of models in category e110 for personal consumption, e115 for personal usage in daily living activities, and e120 for personal outdoor and indoor mobility and transportation. Furthermore, the capacity-performance discrepancy was higher in moderate schizophrenic patients with accessibility barriers in the e110, e115, and e120 categories than that in moderate schizophrenic patients without accessibility barriers. However, severe schizophrenic patients with category e120 accessibility barriers were prone to a lower discrepancy, with institutional care a potentially decreasing factor. In conclusion, providing an e1 barrier-free environment is necessary for patients with schizophrenia to decrease their disability.