I Menendez-Miranda1, M P Garcia-Portilla2, L Garcia-Alvarez3, M Arrojo4, P Sanchez5, F Sarramea6, J Gomar7, M T Bobes-Bascaran8, P Sierra9, P A Saiz2, J Bobes2. 1. Area de Psiquiatria, Universidad de Oviedo, c/Julian Claveria s/n, 33006 Oviedo, Spain. 2. Area de Psiquiatria, Universidad de Oviedo, c/Julian Claveria s/n, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain. 3. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain. Electronic address: lettti@gmail.com. 4. Servicio de Psiquiatría, Complejo Hospitalario Universitario de Santiago, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain. 5. Unidad de Psicosis Refractarias, Hospital Psiquiátrico de Alava, Vitoria, Spain. 6. ESM Montoro, Hospital Reina Sofía de Córdoba, Spain. 7. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Litwin Zucker Alzheimer's Disease Center, Feinstein Institute for Medical Research/AECOM, Manhassett, NY; FIDMAG, Hermanas Hospitalarias Sant Boi de Llobregat, Spain. 8. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain. 9. Servicio de Psiquiatria, Hospital Universitario La Fe, Avda, Fernando Abril Martorell 106, 46026 Valencia, Spain.
Abstract
PURPOSE: This study was performed to identify the predictive factors of functional capacity assessed by the Spanish University of California Performance Skills Assessment (Sp-UPSA) and real-world functioning assessed by the Spanish Personal and Social Performance scale (PSP) in outpatients with schizophrenia. METHODS: Naturalistic, 6-month follow-up, multicentre, validation study. Here, we report data on 139 patients with schizophrenia at their baseline visit. ASSESSMENT: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), Sp-UPSA and PSP. STATISTICS: Pearson's correlation coefficient (r) was used to determine the relationships between variables, and multivariable stepwise linear regression analyses to identify predictive variables of Sp-UPSA and PSP total scores. RESULTS: Functional capacity: scores on the PSP and PANSS-GP entered first and second at P<0.0001 and accounted for 21% of variance (R(2)=0.208, model df=2, F=15.724, P<0.0001). Real-world functioning: scores on the CGI-S (B=-5.406), PANSS-N (B=-0.657) and Sp-UPSA (B=0.230) entered first, second and third, and accounted for 51% of variance (model df=3, F=37.741, P<0.0001). CONCLUSION: In patients with schizophrenia, functional capacity and real-world functioning are two related but different constructs. Each one predicts the other along with other factors; general psychopathology for functional capacity, and severity of the illness and negative symptoms for real-world functioning. These findings have important clinical implications: (1) both types of functioning should be assessed in patients with schizophrenia and (2) strategies for improving them should be different.
PURPOSE: This study was performed to identify the predictive factors of functional capacity assessed by the Spanish University of California Performance Skills Assessment (Sp-UPSA) and real-world functioning assessed by the Spanish Personal and Social Performance scale (PSP) in outpatients with schizophrenia. METHODS: Naturalistic, 6-month follow-up, multicentre, validation study. Here, we report data on 139 patients with schizophrenia at their baseline visit. ASSESSMENT: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), Sp-UPSA and PSP. STATISTICS: Pearson's correlation coefficient (r) was used to determine the relationships between variables, and multivariable stepwise linear regression analyses to identify predictive variables of Sp-UPSA and PSP total scores. RESULTS: Functional capacity: scores on the PSP and PANSS-GP entered first and second at P<0.0001 and accounted for 21% of variance (R(2)=0.208, model df=2, F=15.724, P<0.0001). Real-world functioning: scores on the CGI-S (B=-5.406), PANSS-N (B=-0.657) and Sp-UPSA (B=0.230) entered first, second and third, and accounted for 51% of variance (model df=3, F=37.741, P<0.0001). CONCLUSION: In patients with schizophrenia, functional capacity and real-world functioning are two related but different constructs. Each one predicts the other along with other factors; general psychopathology for functional capacity, and severity of the illness and negative symptoms for real-world functioning. These findings have important clinical implications: (1) both types of functioning should be assessed in patients with schizophrenia and (2) strategies for improving them should be different.
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