Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain.; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Pharmacology Department and Postgraduate Program: Psychiatry and Behavioral Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Eur Neuropsychopharmacol. 2021 Jun;47:98-111. doi: 10.1016/j.euroneuro.2021.02.007. Epub 2021 Feb 28.
Functional impairment is a defining feature of psychotic disorders. The Functional Assessment Short Test (FAST) is one of the most widely used instruments to measure psychosocial functioning. However, cut-offs of impairment have been well-established for bipolar disorders, but not for other clinical populations. This study aims to analyse psychometric properties of the FAST and establish their corresponding cut-off values for the different severity gradations in a first-episode of non-affective psychosis (FEP) patients. Global Assessment Functioning (GAF) and FAST ratings from 212 non-affective FEP and 204 healthy controls were analyzed. The psychometric properties of FAST (internal consistency, concurrent validity, discriminant validity, factorial analyses and sensitivity to change) were analyzed. The severity gradations of the FAST were defined by the congruence between two grading methods: linear regression analysis (LRA) and percentiles. The FAST showed strong psychometric properties. LRA with the GAF scores yielded the following equation: GAF= 80.83 - 0.639*FAST. The FAST ranges in non-affective FEP patients derived from LRA and percentiles, were as follows: 0-9 (No impairment); 10-19 (Minimal impairment); 20-34 (Mild impairment); 35-45 (Moderate impairment); 46-72 (Severe impairment). Patients with no functional impairment had a higher socioeconomic status, fewer depressive and negative symptoms, lower severity of illness and higher cognitive reserve level than the others groups. In conclusion, the FAST shows optimal psychometric properties which corroborate its applicability in FEP populations. It is a well-demonstrated valid instrument and the present cut-off scores could be implemented in clinical and research practice to assess properly the psychosocial functional outcome of non-affective FEP populations.
功能障碍是精神障碍的一个重要特征。功能评估简短测试（FAST）是测量心理社会功能最广泛使用的工具之一。然而，双相情感障碍的损伤截断值已经得到很好的建立，但其他临床人群则没有。本研究旨在分析首次发作非情感性精神病（FEP）患者中 FAST 的心理测量特性，并为其不同严重程度分级建立相应的截断值。对 212 名非情感性 FEP 和 204 名健康对照者的 FAST 和总体评估功能（GAF）评分进行了分析。分析了 FAST 的心理测量特性（内部一致性、同时效度、判别效度、因子分析和对变化的敏感性）。使用两种分级方法（线性回归分析（LRA）和百分位数）之间的一致性来定义 FAST 的严重程度分级。FAST 具有很强的心理测量特性。与 GAF 评分的 LRA 产生以下方程：GAF=80.83-0.639*FAST。LRA 和百分位数得出的非情感性 FEP 患者 FAST 范围如下：0-9（无损伤）；10-19（轻度损伤）；20-34（轻度损伤）；35-45（中度损伤）；46-72（严重损伤）。无功能损伤的患者比其他组具有更高的社会经济地位、更少的抑郁和阴性症状、更低的疾病严重程度和更高的认知储备水平。总之，FAST 具有最佳的心理测量特性，证实了其在 FEP 人群中的适用性。它是一种经过充分验证的有效工具，目前的截断分数可在临床和研究实践中实施，以适当评估非情感性 FEP 人群的心理社会功能结局。
