Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden.
Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden.
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DOI：
10.1176/appi.ajp.2009.09010106
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Patterson TL
中科院分区：
文献类型：
--
作者：
Harvey PD;Helldin L;Bowie CR;Heaton RK;Olsson AK;Hjärthag F;Norlander T;Patterson TL
精神分裂症残疾评估的最新进展已经将功能能力（在结构化评估中执行日常功能技能的能力）的测量与现实世界的功能结果分开。本研究探讨了美国和瑞典精神分裂症患者日常功能、现实世界残疾和里程碑成就的基于表现的评估的相似性。生活在瑞典农村地区（n=146）和纽约（n=244）的精神分裂症患者样本进行了简短版本的UCSD基于表现的技能评估（UPSA-B）和神经心理学评估，并由他们的病例管理者对功能进行了评级。来自记录和案例管理员的信息被用来确定独立生活，工作和经历过稳定的浪漫关系的频率。两个样本的UPSA-B性能基本相同（纽约，M=13.84;瑞典，M=13.30）。案例经理对日常活动的评分也是如此（纽约：M=49.0;瑞典：M=48.8）。UPSA-B分数，NP测试性能，和SLOF评级之间的相关性在两个样本中没有差异。从未有过亲密关系的病例比例和职业残疾率也几乎相同。相比之下，80%的瑞典患者和46%的纽约患者独立生活。不同文化背景下的精神分裂症患者在日常生活技能的绩效指标上的得分非常相似。相比之下，现实世界的住宅结果是非常不同的。这些数据表明，文化和社会支持系统可能会导致具有相同能力和潜力的个人在现实世界中产生不同的结果。
Recent advances in the assessment of disability in schizophrenia have separated the measurement of functional capacity (the ability to perform everyday functioning skills in structured assessments) from real-world functional outcomes. This study examined the similarity of performance-based assessments of everyday functioning, real-world disability, and achievement of milestones in people with schizophrenia in the United States and in Sweden. Samples of schizophrenia patients living in rural areas in Sweden (n=146) and in New York (n=244)) performed the brief version of the UCSD Performance-based Skills Assessment (UPSA-B) and a neuropsychological assessment and were rated for functioning by their case managers. Information from records and case managers was used to determine the frequency of living independently, working, and having ever experienced a stable romantic relationship. Performance on the UPSA-B was essentially identical in the two samples (New York, M=13.84; Sweden, M=13.30). So were scores on the case manager ratings of everyday activities (New York: M=49.0; Sweden: M=48.8). The correlations between UPSA-B scores, NP test performance, and SLOF ratings did not differ across the two samples. The proportion of cases who had never had a close relationship and rates of vocational disability were also nearly identical. In contrast, 80% of the Swedish patients and 46% of the New York patients were living independently. Scores on performance-based measures of everyday living skills were very similar in people with schizophrenia across cultures. In contrast, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to divergent real-world outcomes in individuals who have evidence of the same levels of ability and potential.
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