Juckel Georg, Schaub Daniela, Fuchs Nina, Naumann Ute, Uhl Idun, Witthaus Henning, Hargarter Ludger, Bierhoff Hans-Werner, Brüne Martin
Department of Psychiatry, Ruhr University Bochum, LWL Hospital, Germany.
Schizophr Res. 2008 Sep;104(1-3):287-93. doi: 10.1016/j.schres.2008.04.037. Epub 2008 Jul 1.
In trying to more broadly define outcome in the efficient long-term treatment of patients with schizophrenia it is necessary to consider not only a reduction in psychopathological symptoms but also a successful psychosocial reintegration. Thus, a more exact assessment of psychosocial functioning is needed. Since the GAF (Global Assessment of Functioning) scale and the SOFAS (Social and Occupational Functioning Assessment Scale) are less operationalized and confuse psychosocial facts with psychopathological symptoms, the Personal and Social Performance (PSP) scale was developed [Morosini, P.L., Magliano, L., Brambilla, L., Ugolini, S., Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 1001, 323-329.] containing the four main areas "socially useful activities, personal and social relationships, self-care, as well as disturbing and aggressive behaviour". Validation of the PSP scale was conducted in a sample of 62 patients with acute schizophrenia. Rating instruments were PSP, GAF, SOFAS, PANSS, CGI, and Mini-ICF-P (Mini-ICF-Rating for Mental Disorders). The results showed good reliability with alpha=.64-.84, high test-retest reliability as well as good inter-rater reliability for the PSP scale. Furthermore, PSP proved good validity with high correlations to GAF (r=.91), SOFAS (r=.91), and Mini-ICF-P (r=-.69). The hypothesis that more critically ill patients would show lower scores on PSP than lesser ill patients was only confirmed for PANSS negative symptoms. Thus, the findings prove the PSP scale to be a reliable and valid instrument for assessing social functioning of patients with schizophrenia during the course of treatment as well as in the acute state.
在试图更广泛地定义精神分裂症患者有效长期治疗的结果时,不仅需要考虑精神病理症状的减轻,还需要考虑成功的心理社会重新融入。因此,需要对心理社会功能进行更精确的评估。由于全球功能评估(GAF)量表和社会与职业功能评估量表(SOFAS)的操作性较差,且将心理社会事实与精神病理症状相混淆,因此开发了个人和社会表现(PSP)量表[莫罗西尼,P.L.,马利亚诺,L.,布兰比拉,L.,乌戈利尼,S.,皮奥利,R.(2000年)。用于评估日常社会功能的新版DSM-IV社会与职业功能评估量表(SOFAS)的开发、信度和可接受性。《斯堪的纳维亚精神病学学报》,1001,323 - 329],其中包含“社会有益活动、个人和社会关系、自我照顾以及干扰和攻击性行为”这四个主要领域。PSP量表的验证是在62例急性精神分裂症患者的样本中进行的。评定工具包括PSP、GAF、SOFAS、阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)以及精神障碍的简易国际功能、残疾和健康分类评定量表(Mini - ICF - P)。结果显示,PSP量表的信度良好,α系数为0.64 - 0.84,重测信度高,评定者间信度也良好。此外,PSP量表与GAF(r = 0.91)、SOFAS(r = 0.91)和Mini - ICF - P(r = - 0.69)高度相关,证明其效度良好。关于病情较重的患者在PSP量表上的得分会低于病情较轻患者的假设,仅在PANSS阴性症状方面得到证实。因此,研究结果证明PSP量表是评估精神分裂症患者在治疗过程中以及急性期社会功能的可靠且有效的工具。