The Impact of Symptomatology on Response to a Health Promoting Intervention Among Older Adults with Schizophrenia

Purpose: To explore the relationship between the symptoms of schizophrenia experienced by older persons diagnosed with schizophrenia and type 2 diabetes mellitus and their response to a health promoting intervention.

Methods: Secondary data analysis of data obtained from a lifestyle intervention program that recruited participants over age 40 with schizophrenia or schizoaffective disorder and type 2 diabetes mellitus from board-and-care facilities and day treatment programs. Participants had been randomly assigned to a 24-week diabetes awareness and rehabilitation training (DART; n = 32) or a usual care plus information (UCI; n = 32) comparison group. Baseline and 6-month (intervention completion) assessments included a diabetes knowledge test (DKT), diabetes self-efficacy measured by the diabetes empowerment scale (DES), and symptomatology defined by the Positive and Negative Syndrome Scale (PANSS). Simple linear regression models in 3 steps were used to analyze the data.

Results: A significant condition by symptom interaction was found for DKT. The difference between change in knowledge for DART and UCI groups depended on the prevalence and severity of the total, negative, and general symptoms. There was no significant condition by positive symptom interaction for DKT. A significant main effect was found between total, negative, positive, and general symptoms in the total sample for improvement in DES scores. Higher prevalence and severity of symptoms was negatively associated with improvement in DES scores.

Conclusion: Researchers need to consider the impact of schizophrenia symptoms in response to health promoting interventions.