Self-assessment of functional status in schizophrenia
Self-assessment of functional status in schizophrenia
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DOI：
10.1016/j.jpsychires.2006.08.003
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发表时间：
2007-12-01
影响因子：
4.8
通讯作者：
Harvey, Philip D.
中科院分区：
文献类型：
--
作者：
Bowie, Christopher R.;Twamley, Elizabeth W.;Harvey, Philip D.
随着针对与功能残疾相关的精神分裂症特征的新治疗，有必要评估日常结果评级的有效性。目前尚不清楚患者是否能够有效地自我报告其功能状态的各个方面，这将是获得结果数据的一种潜在的经济方法。在这项研究中，67名老年精神分裂症门诊患者使用特定功能水平量表(SLOF)对日常现实世界功能进行自我评级。他们还接受了神经心理表现、基于表现的功能能力和社交技能、临床症状和生活质量的评估。案例经理在不知道其他评级的情况下，也产生了SLOF评级。根据差异分数，参与者被分为准确评分者(n=24)、低估者(n=16)或高估者(n=27)，与病例经理的评分相比。患者自我评估的功能状态与他们的主观生活质量相关，但与病例经理对功能状态的评分或他们自己在功能能力或社交技能方面的表现没有显著的相关性。然而，案例经理的评级与功能能力和社交技能方面的表现高度相关。那些低估了自己在现实世界中的表现的患者比高估了自己的患者有更好的认知技能和更严重的自我评估抑郁。准确的评分者表现出比高估和低估者更强的社交技能，而高估者在认知和功能上受到的损害最大。对精神分裂症患者日常结果的准确评级可能需要对现实世界结果进行系统观察或基于表现的衡量标准，因为自我报告与客观信息不一致。(C)2006爱思唯尔有限公司。保留所有权利。
With new treatments targeting features of schizophrenia associated with functional disability, there is a need to evaluate the validity of ratings of everyday outcomes. It is unknown whether patients can validly self-report on aspects of their functional status, which would be a potentially economical method for obtaining outcome data. In this study, 67 older schizophrenia outpatients provided self-ratings of everyday real-world functioning using the specific levels of functioning scale (SLOF). They were also administered assessments of neuropsychological performance, performance-based measures of functional capacity and social skills, clinical symptoms, and quality of life. Case managers, unaware of other ratings, also generated SLOF ratings. Based on discrepancy scores, participants were categorized as accurate raters (n = 24), underestimators (n = 16), or overestimators (n = 27) of their functional status as compared to case managers' ratings. Patients' self-rated functional status was correlated with their subjective quality of life, but remarkably unassociated with case manager ratings of functional status or their own performance on functional capacity or social skills measures. Case manager ratings, however, were highly correlated with performance on functional capacity and social skills measures. Patients who underestimated their real world performance had better cognitive skills and greater self-rated depression than those who overestimated. Accurate raters demonstrated greater social skills than both overestimators and underestimators, while overestimators were most cognitively and functionally impaired. Accurate ratings of everyday outcomes in schizophrenia may require systematic observation of real world outcomes or performance-based measures, as self-reports were inconsistent with objective information. (c) 2006 Elsevier Ltd. All rights reserved.