Levels of Recovery Scale (LORS): psychometric properties of a new instrument to assess psychotic symptoms and patient awareness.

This study developed norms and examined psychometric properties of the LORS, an instrument designed to assess symptoms of psychotic illness and patients' awareness of their symptoms. Participants were 90 patients with psychotic illnesses. The LORS was completed by trained clinicians (LORS-Clinician Scale) and patients themselves (LORS-Patient). To assess patients' self-awareness of psychotic symptoms, a derived scale (LORS-Discrepancy) was computed by subtracting the LORS-Patient Scale score from the LORS-Clinician Scale score. All scales showed good test-retest reliability. The LORS-Clinician Scale showed good concurrent validity. LORS-Patient Scale scores were significantly lower than LORS-Clinician Scale scores, suggesting that patients underestimated their psychotic symptoms. Patients with low awareness of their psychotic symptoms showed less appropriate functioning, more problems in complying with their medication regimens, and increased positive and negative symptoms of schizophrenia. Implications for developing treatments using the LORS-Discrepancy Scale were discussed.