Olvet Doreen M, Carrión Ricardo E, Auther Andrea M, Cornblatt Barbara A
Psychiatry Research, North Shore - Long Island Jewish Health System, The Zucker Hillside Hospital, Glen Oaks, New York, USA.
Early Interv Psychiatry. 2015 Apr;9(2):100-7. doi: 10.1111/eip.12086. Epub 2013 Aug 22.
A major public health concern associated with schizophrenia is the long-term disability that involves an inability to function independently in the community. An individual's self-awareness of functional impairment may be a significant factor contributing to long-term disability. In fact, subjective interpretation of one's illness impacts treatment participation and adherence, and is linked to poor outcomes. However, it remains unclear how illness-related functional impairment is perceived by individuals prior to the onset of psychosis. This study aims to examine the relationship between clinician-based and self-report assessments of functioning, as well as the contribution of clinical symptoms to this relationship in individuals at clinical high-risk for psychosis.
The Sheehan Disability Scale, a self-rated instrument, was used to measure disruption in daily functioning in social and role functioning due to symptoms in a sample of 73 treatment-seeking patients at clinical high-risk for psychosis and 50 healthy controls.
Relative to healthy controls, clinical high-risk patients self-reported significant disruptions in social and role functioning. In addition, a specific relationship emerged in that clinician-rated measures of functioning and depression were related to subjective functioning.
These findings suggest that clinical high-risk patients are significantly disturbed by their illness. Self-reported disruption of daily functioning was associated with clinician-rated functioning and depressive symptoms, further highlighting the impact of functional impairments on the level of distress experienced by patients in the early phases of the illness. Intervention strategies that repair functional impairment before the onset of psychosis may prevent long-term disability.
与精神分裂症相关的一个主要公共卫生问题是长期残疾，这涉及到无法在社区中独立生活。个体对功能障碍的自我认知可能是导致长期残疾的一个重要因素。事实上，对自身疾病的主观解读会影响治疗参与度和依从性，并与不良预后相关。然而，目前尚不清楚在精神病发作之前，个体是如何看待与疾病相关的功能障碍的。本研究旨在探讨基于临床医生评估和自我报告的功能评估之间的关系，以及临床症状对处于精神病临床高危状态个体中这种关系的影响。
使用自评工具希恩残疾量表，测量73名寻求治疗的精神病临床高危患者和50名健康对照样本中，由于症状导致的社交和角色功能日常功能的破坏。
相对于健康对照，临床高危患者自我报告在社交和角色功能方面有显著破坏。此外，出现了一种特定的关系，即临床医生评定的功能和抑郁测量与主观功能相关。
这些发现表明，临床高危患者受到疾病的严重困扰。自我报告的日常功能破坏与临床医生评定的功能和抑郁症状相关，进一步突出了功能障碍对疾病早期患者痛苦程度的影响。在精神病发作前修复功能障碍的干预策略可能预防长期残疾。
