Aix-Marseille Univ, EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, 13005 Marseille, France.
Compr Psychiatry. 2013 Oct;54(7):1016-22. doi: 10.1016/j.comppsych.2013.04.008. Epub 2013 May 31.
The aim of this study was to develop a functional remission threshold for the Functional Remission Of General Schizophrenia (FROGS) scale, and test its validity regarding clinical and quality of life outcomes.
Cross-sectional study.
Schizophrenia according to DSM-IV-TR criteria.
Functioning was assessed using the FROGS and the Global Assessment of Functioning (GAF) scales; psychotic symptoms using the Positive and Negative Syndrome Scale; memory, attention, and executive functions were assessed using the California Verbal Learning Test, the D2 attention task, the Stroop color-word test, the verbal fluency test, the Trail Making Test A and B and the Wechsler Adult Intelligence Scale; and quality of life using the schizophrenia quality of life (S-QoL 18) scale.
A logistic regression analysis including the different dimensions of the FROGS was used to create a composite score to classify patients into remitted and non-remitted according a gold standard (cut-off: GAF>= 61). Receiver operating characteristics analyses were then performed to determine the area under the curve (AUC).
Of 137 patients enrolled, 26 were functionally remitted and 111 were not remitted according to GAF score. The AUC for the combination of the FROGS's dimensions to detect functional remission was 0.903 (p<0.001). Sensitivity and specificity for the combination of the FROGS dimensions using the Youden index were 88.5 [69.8; 97.6] and 81.1 [72.5; 87.9], respectively. Validity of this combination was satisfactory. Patients in functional remission had a lower severity of the disease, especially for PANSS negative (p<0.001) and general psychopathology (p<0.001) symptoms. Only two cognitive functions (i.e. fluency and episodic memory) were improved in remitted patients. Higher quality of life levels were globally associated with better functioning.
These findings provide for first accurate FROGS thresholds to detect functional remission in schizophrenia.
本研究旨在为功能性总体精神分裂症缓解量表（FROGS）制定一个功能缓解阈值，并检验其在临床和生活质量结局方面的有效性。
横断面研究。
根据 DSM-IV-TR 标准诊断为精神分裂症。
使用 FROGS 和总体功能评估量表（GAF）评估功能；使用阳性和阴性综合征量表评估精神病症状；使用加利福尼亚语言学习测验、D2 注意任务、Stroop 颜色词测验、言语流畅性测验、Trail Making Test A 和 B 以及韦氏成人智力量表评估记忆、注意力和执行功能；使用精神分裂症生活质量量表（S-QoL 18）评估生活质量。
采用逻辑回归分析纳入 FROGS 的不同维度，创建一个综合评分，根据金标准（截断值：GAF≥61）将患者分为缓解和未缓解组。然后进行受试者工作特征曲线分析以确定曲线下面积（AUC）。
共纳入 137 例患者，根据 GAF 评分，26 例患者为功能缓解，111 例患者为功能未缓解。FROGS 各维度联合检测功能缓解的 AUC 为 0.903（p<0.001）。使用约登指数，FROGS 各维度联合的敏感性和特异性分别为 88.5[69.8;97.6]和 81.1[72.5;87.9]。该联合的有效性令人满意。功能缓解的患者疾病严重程度较低，特别是 PANSS 阴性症状（p<0.001）和一般精神病理症状（p<0.001）。仅两种认知功能（即流畅性和情节记忆）在缓解患者中得到改善。整体而言，更高的生活质量水平与更好的功能相关。
这些发现为 FROGS 检测精神分裂症功能缓解提供了首个准确的阈值。
