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Overestimated function in patients with schizophrenia: A possible risk factor for inadequate support?
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0002-1088-9793
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
2018 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, article id S0920-9964(18)30678-9Article in journal (Refereed) Epub ahead of print
Abstract [en]

People with schizophrenia often demonstrate an impaired ability to assess and report aspects of their everyday functioning, and the aim of this study is to investigate how patients' self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. A total of 222 outpatients with a schizophrenia spectrum disorder participated in this study. They were divided into groups based on their self-rating ability (determined using self-rating questions) and their observed functional capacity (the UCSD Performance-Based Skills Assessment-Brief, UPSA-B). The results showed that patients with impaired functional capacity perform at a similar cognitive level, regardless of their self-rating ability. When comparing patients with unimpaired function to those with impaired function, we found differences in two cognitive domains; premorbid functioning and executive functioning. The results also reveal that clinicians seem to have greater difficulty assessing patients who over-estimate their functioning. Consequently, when clinicians assessed the patients with the Specific Levels of Functioning Scale (SLOF) no significant differences were found between the group with unimpaired function and the group of overestimators. Patients who overestimate their functioning risk receiving inadequate treatment and support.

Place, publisher, year, edition, pages
Elsevier, 2018. article id S0920-9964(18)30678-9
Keywords [en]
Functional capacity, Introspective accuracy, Neurocognition, Real-world functional outcomes, Schizophrenia, Self-awareness
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-70680DOI: 10.1016/j.schres.2018.11.027ISI: 000467810100028PubMedID: 30514644OAI: oai:DiVA.org:kau-70680DiVA, id: diva2:1276473
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-05-31Bibliographically approved
In thesis
1. Functional Capacity as a Predictor of Everyday Functioning in Patients with Schizophrenia
Open this publication in new window or tab >>Functional Capacity as a Predictor of Everyday Functioning in Patients with Schizophrenia
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall purpose of this thesis is to increase knowledge of the concept of functional capacity and how it is related to everyday functioning for adult patients with schizophrenia spectrum disorders. The thesis comprises three papers (Papers I-III) based on empirical data from a clinically representative sample of outpatients. The results in the first study (Paper I) indicated that the Swedish version of University of California San Diego Performance-based Skills Assessment-Brief (UPSA-B) is a reliable instrument, with good psychometric properties in terms of both validity and reliability. UPSA-B is a performance-based instrument used to assess functional capacity, i.e. the patient’s ability to perform certain everyday tasks, necessary for independent functioning, in a controlled setting. In the second study (Paper II), the aim was to investigate if and how demographic variables and illness activities, together with functional capacity, contribute to predicting real-world functioning milestones. Functional capacity was mainly associated with education level and housing situation. In the third study (Paper III), the aim was to investigate how the patient's self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. The results showed that 37% of patients overestimate their functional performance. The results also showed that clinicians seem to have greater difficulty assessing patients who overestimate their functioning. In summary, this thesis states that using UPSA-B to measure functional capacity offers considerable advantages and plays an important role in capturing functional outcomes. The importance of taking control of limited self-rating ability in patients with schizophrenic spectrum disorders is also demonstrated.

Abstract [en]

The overall purpose of this thesis is to increase knowledge about the concept of functional capacity and the way it is related to everyday functioning for adult patients with schizophrenia spectrum disorders. UCSD Performance-based Skill Assessment-Brief (UPSA-B) is a performance based instrument used to assess functional capacity, the patient’s ability to perform certain everyday tasks in a controlled setting. The result in Paper I indicated that the Swedish version of UPSA-B is a reliable instrument with good psychometric properties. The aim in Paper II was to investigate if and how, demographic variables and illness activities together with functional capacity contribute to predict real-world functioning milestones. Functional capacity was mainly associated with education level and housing situation. In Paper III the aim was to investigate how the patient's self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. The results showed that 37 % of patients overestimate their ability of functional performance. In sum, this thesis states that using UPSA-B to measure functional capacity has great advantages and plays an important role in capturing functional outcomes.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2019. p. 86
Series
Karlstad University Studies, ISSN 1403-8099 ; 2019:2
Keywords
Schizophrenia, Functional capacity, Everyday functioning, Self-awareness, Assessment instrument
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-70681 (URN)978-91-7063-833-6 (ISBN)978-91-7063-866-4 (ISBN)
Public defence
2019-02-22, 1B 309 Sjöströmsalen, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2019-02-01 Created: 2019-01-08 Last updated: 2019-06-05Bibliographically approved

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Olsson, Anna-KarinHjärthag, FredrikHelldin, Lars

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