Garcia-Portilla María Paz, Gomar Jesús, Bobes-Bascaran María Teresa, Menendez-Miranda Isabel, Saiz Pilar Alejandra, Muñiz José, Arango Celso, Patterson Thomas, Harvey Philip, Bobes Julio, Goldberg Terry
Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España.
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España; Litwin Zucker Alzheimer's Disease Center, Feinstein Institute for Medical Research/Hofstra North Shore LIJ Scholl of Medicine, Manhassett, Nueva York, Estados Unidos; FIDMAG, Hermanas Hospitalarias Sant Boi de Llobregat, España.
Rev Psiquiatr Salud Ment. 2014 Jul-Sep;7(3):113-20. doi: 10.1016/j.rpsm.2014.02.003. Epub 2014 Jun 29.
In patients with severe mental disorders outcome measurement should include symptoms, cognition, functioning and quality of life at least. Shorter and efficient instruments have greater potential for pragmatic and valid clinical utility. Our aim was to develop the Spanish UPSA Brief scale (Sp-UPSA-Brief).
Naturalistic, 6-month follow-up, multicentre study. 139 patients with schizophrenia, 57 with bipolar disorder and 31 controls were evaluated using the Sp-UPSA, CGI-S, GAF, and PSP. We conducted a multivariate linear regression model to identify candidate subscales for the Sp-UPSA-Brief.
The stepwise regression model for patients with schizophrenia showed that communication and transportation Sp-UPSA subscales entered first and second at p<0.0001 (R(2)=0.88, model df=2, F=395.05). In patients with bipolar disorder transportation and communication Sp-UPSA subscales entered first and second at p<0.0001 (R(2)=0.87, model df=2, F=132.32). Cronbach's alpha was 0.78 in schizophrenia and 0.64 in bipolar patients. Test-retest was 0.66 and 0.64 (p<0.0001) respectively. Pearson correlation coefficients between Sp-UPSA and Sp-UPSA-Brief were 0.93 for schizophrenia and 0.92 for bipolar patients (p<0.0001).The Sp-UPSA-Brief discriminated between patients and controls. In schizophrenia patients it also discriminated among different levels of illness severity according to CGI-S scores.
The Sp-UPSA-Brief is an alternate instrument to evaluate functional capacity that is valid and reliable. Having a shorter instrument makes it more feasible to assess functional capacity in patients with severe mental disorders, especially in everyday clinical practice.
对于重症精神障碍患者,结局测量至少应包括症状、认知、功能和生活质量。更简短且有效的工具在实用和有效的临床应用方面具有更大潜力。我们的目标是开发西班牙版简易UPSA量表(Sp-UPSA-Brief)。
自然主义的、为期6个月的随访、多中心研究。使用Sp-UPSA、CGI-S、GAF和PSP对139例精神分裂症患者、57例双相情感障碍患者和31名对照者进行评估。我们进行了多元线性回归模型以确定Sp-UPSA-Brief的候选子量表。
精神分裂症患者的逐步回归模型显示,沟通和交通方面的Sp-UPSA子量表分别以p<0.0001的显著性水平首先和其次进入模型(R(2)=0.88,模型自由度=2,F=395.05)。双相情感障碍患者中,交通和沟通方面的Sp-UPSA子量表分别以p<0.0001的显著性水平首先和其次进入模型(R(2)=0.87,模型自由度=2,F=132.32)。精神分裂症患者的Cronbach's α系数为0.78,双相情感障碍患者为0.64。重测信度分别为0.66和0.64(p<0.0001)。精神分裂症患者中Sp-UPSA与Sp-UPSA-Brief之间的Pearson相关系数为0.93,双相情感障碍患者为0.92(p<0.0001)。Sp-UPSA-Brief能够区分患者和对照者。在精神分裂症患者中,它还能根据CGI-S评分区分不同疾病严重程度水平。
Sp-UPSA-Brief是一种评估功能能力的有效且可靠的替代工具。拥有更简短的量表使得在重症精神障碍患者中评估功能能力更可行,尤其是在日常临床实践中。