Department of Psychiatry, Faculty of Medicine, Hospital Santa Maria, University of Lisbon, Portugal.
Curr Opin Psychiatry. 2011 Mar;24(2):91-9. doi: 10.1097/YCO.0b013e3283438119.
Improvement in psychosocial functioning is nowadays considered an important and achievable goal of schizophrenia treatment. Therefore, treatment interventions are expected to have a positive influence both on symptoms and on social integration.In this nonsystematic literature review, we describe some of the available measures to assess social outcomes in schizophrenia treatment and their inherent limitations, and discuss future directions for research and clinical practice.
The lack of consensus on the appropriate terminology and standards applied to index patients' level of functioning remains an obstacle in assessing psychosocial outcomes in schizophrenia. Although some scales appear advantageous in terms of ease of administration and reliability, they lack enough solid evidence that they are related to real-world outcomes or sensitive to change. Performance-based measures are being more widely used to assess functional capacity because they appear effective in predicting independent living and work, as compared with both self-report and clinical measures.
We argue that assessment of psychosocial functioning should be an integral part of schizophrenia patients' assessment, in both the research and clinical setting. Ultimately, there exists no gold standard measure, but, of those available, the Personal and Social Performance (PSP) Scale and the UCSD Performance-based Skills Assessment (UPSA) have literature supporting their usefulness for assessing psychosocial outcomes in schizophrenia patients.
改善心理社会功能,如今被认为是精神分裂症治疗的一个重要且可实现的目标。因此,治疗干预措施有望对症状和社会融合产生积极影响。在本次非系统性文献综述中,我们描述了一些用于评估精神分裂症治疗中社会结局的现有措施及其内在局限性,并讨论了未来的研究和临床实践方向。
在评估精神分裂症患者的功能水平时,术语和适用标准缺乏共识,这仍然是一个障碍。尽管一些量表在管理简便性和可靠性方面具有优势,但它们缺乏足够的坚实证据表明它们与现实结果相关或对变化敏感。基于表现的测量方法正越来越多地用于评估功能能力,因为与自我报告和临床测量相比,它们似乎能有效地预测独立生活和工作能力。
我们认为,在研究和临床环境中,心理社会功能评估都应该是精神分裂症患者评估的一个组成部分。最终,没有黄金标准的衡量措施,但在现有的衡量措施中,个人和社会表现量表和加州大学圣地亚哥分校基于表现的技能评估量表具有支持其在评估精神分裂症患者心理社会结局方面的有用性的文献。