Assessing everyday functioning in schizophrenia: Not all informants seem equally informative☆,☆☆
Section snippets
Subjects
The study participants were patients with schizophrenia who were receiving treatment at one of three different outpatient service delivery systems, two in Atlanta and one in San Diego. In addition, informants were interviewed for each of the patients, with these informants either being a high-contact clinician (case manager, psychiatrist, therapist or residential facility manager) or a friend or relative. All of research participants (including informants) provided signed, informed consent, and
Results
Table 1 presents the demographic and clinical characteristics of the patient samples as a function of the type of informant. As we examined the convergence in reports between patients and informants as a function of the different informant types, we were interested in whether these samples of patients who had different informants were different from each other. Patients who were rated by clinicians were more likely to be Caucasian, were younger, and had more years of education (all p ≤ 0.03).
Discussion
Our study revealed that across six different functional status rating scales, patients generated self-reports that were modestly correlated with informant reports, including both clinicians and friend/relatives serving as informants. The severity levels of each measure were only slightly different for the two measures that differed significantly (SBS and QLS), with patients under-reporting impairment when compared to both types of informants. Overall, clinician reports were more consistently
Role of funding source
This research was funded by the National Institute of Mental Health, who provided no input into the analyses and presentation of these data.
Contributors
Drs. Harvey, Heaton, and Patterson designed the overall study and obtained funding. Dr. Sabbag conceptualized and conducted the current analyses and wrote the first draft of the paper. Dr. Harvey provided scientific oversight throughout the project and edited the manuscript. Drs Heaton, Patterson, and Twamley and Ms Vella provided detailed comments to the paper across three drafts of the manuscript.
Conflict of interest
Dr. Harvey has received consulting fees for Abbott Labs, BMS, Cypress Bioscience,, En Vivo, Genentech, Merck and Company, Shire Pharma, Sunovion Pharma, and Takeda Pharma during the past year. He has received research funding from Astra-Zeneca. None of the other authors have any commercial interests to report.
Acknowledgments
All individuals who contributed to this paper are listed as authors. No professional medical writer was involved in any portion of the preparation of the manuscripts. Data were collected by paid research assistants who did not contribute to the scientific work in this paper.
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2019, Psychiatry ResearchCitation Excerpt :Direct observation is the best way to assess functioning in naturalistic settings, however, can be time consuming. Around one third of schizophrenia patients do not have a caregiver or significant-other to provide proxy-ratings (Patterson et al., 1996), and for those that do, not all caregivers are equally informative, even those with levels of “high contact” (Sabbag et al., 2011). On the contrary, performance-based assessments require patients to perform a skill in a controlled environment designed to simulate and mirror the real-world.
Comprehensive review of the research employing the schizophrenia cognition rating scale (SCoRS)
2019, Schizophrenia ResearchCitation Excerpt :This strategy can be affected by several different biases, including halo effects, omission of key information, or gaps in knowledge of the individual, which can result in either over-estimation or under-estimation of an individual's proficiency (Loewenstein et al., 2001). One way to increase sensitivity in these interview-based measures might be to use performance-based measures, including performance on neuropsychological tests, as a reference point for the quality of the reports of different classes of informants (Sabbag et al., 2011). Interviews conducted with individuals with schizophrenia have been examined in several different studies for their convergence with performance-based assessments of cognition.
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This research was supported by Grants MH078775 to Dr. Harvey and MH078737 to Dr. Patterson from the National Institute of Mental Health.
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Dr. Harvey has received consulting fees from Abbott Labs, Bristol Myers Squibb, Cypress Bioscience, En Vivo, Genentech, Merck and Company, Shire Pharma, Sunovion Pharma, and Takeda Pharma, during the past year. None of the other authors have any commercial interests to report. This study was funded by the NIMH and is unrelated to Dr. Harvey's Consulting work.