Joseph Jamie, Kremen William S, Glatt Stephen J, Franz Carol E, Chandler Sharon D, Liu Xiaohua, Johnson Barbara K, Tsuang Ming T, Twamley Elizabeth W
Center for Behavior Genomics, Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive #0603, La Jolla, CA 92093-0603, USA.
Center for Behavior Genomics, Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive #0603, La Jolla, CA 92093-0603, USA; Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive (116A), San Diego, CA 92161, USA.
J Psychiatr Res. 2015 Jun;65:102-7. doi: 10.1016/j.jpsychires.2015.04.001. Epub 2015 Apr 11.
Schizophrenia has been characterized as a disorder with poor outcomes across various functional domains, especially social and occupational functioning. Although these outcomes have been investigated based on patients' current functioning, few studies have considered the assessment of functional outcomes across the lifespan in schizophrenia. We developed a novel and brief scale of adulthood lifespan functioning, the Assessment of Lifespan Functioning Attainment (ALFA). We assessed current functioning and percentage of pre- and post-psychosis onset engagement for five functional domains including paid employment, living independently, romantic partnerships, close friendships, and recreational engagement with others. Pre-to post-psychosis functional decline was observed for all domains, with paid employment having the greatest decline (d = 2.68) and living independently having the least decline (d = .59). Our exploratory factor analysis suggests that a single factor accounted for the most variance in Pre-Psychosis Functioning in ALFA domains. Two factors explain the majority of variance in Post-Psychosis Functioning and Pre-to-Post Psychosis Decline: a sociability factor (close friendships and recreational engagement with others) and an independence factor (paid employment, living independently, romantic relationships). To our knowledge, this is the first study to report on a self-reported quantitative assessment of adult lifespan functioning in schizophrenia. The ALFA scale may be a useful tool for future research on functional outcomes in schizophrenia.
精神分裂症被认为是一种在各个功能领域预后不良的疾病，尤其是在社交和职业功能方面。尽管已经基于患者当前的功能状况对这些预后进行了研究，但很少有研究考虑对精神分裂症患者整个生命周期的功能预后进行评估。我们开发了一种新颖且简短的成年期生命周期功能量表，即生命周期功能达成评估量表（ALFA）。我们评估了五个功能领域（包括有偿就业、独立生活、恋爱关系、亲密友谊以及与他人的娱乐活动）在精神病发作前后的当前功能状况以及参与程度百分比。所有领域均观察到精神病发作前后的功能下降，其中有偿就业的下降幅度最大（d = 2.68），独立生活的下降幅度最小（d = 0.59）。我们的探索性因素分析表明，一个单一因素在ALFA量表各领域的精神病发作前功能状况中占最大方差。两个因素解释了精神病发作后功能状况和精神病发作前后功能下降的大部分方差：一个社交性因素（亲密友谊以及与他人的娱乐活动）和一个独立性因素（有偿就业、独立生活、恋爱关系）。据我们所知，这是第一项报告对精神分裂症患者成年期生命周期功能进行自我报告式定量评估的研究。ALFA量表可能是未来精神分裂症功能预后研究的一个有用工具。
