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Schizophrenia Bulletin Advance Access originally published online on November 20, 2008
Schizophrenia Bulletin 2009 35(2):307-318; doi:10.1093/schbul/sbn152
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

A Review of Instruments for Measuring Functional Recovery in Those Diagnosed With Psychosis

Brent T. Mausbach1,2, Raeanne Moore3, Christopher Bowie4, Veronica Cardenas2 and Thomas L. Patterson2
2 Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680
3 Alliant International University, San Diego, CA
4 Department of Psychology, Queen's University, Ontario, Canada

1 To whom correspondence should be addressed; tel: 858-822-5925, fax: 858-534-7723, e-mail: bmausbach{at}ucsd.edu.

The task of judging an individual's functional recovery is not an easy one for healthcare professionals. Indeed, increasing one's accuracy in predicting one's ability to self-maintain would be of great value for determining if functional recovery has or is occurring. The purpose of this review is to examine existing measures for assessing remission/normalization of functional status among people with psychosis. Our review evaluates 8 measures of functional ability encompassing self-report, clinical, and performance-based measures. We elected to utilize a grading system to aid readers in understanding the merit of a scale for use in assessing functional recovery. In this approach, a letter grade (A, B, or C) was assigned to each of 4 domains we deemed important to professionals in electing to use specific assessments: (1) Ease of Administration, (2) Reliability, (3) Validity/Relationship to Real-World Outcomes, and (4) Sensitivity to Change/Use in Clinical Trials. Results indicated that no "gold standard" measure has been developed to date, but performance-based measures appear to have the most evidence for predicting concurrent self-maintenance abilities (eg, residing independently or maintaining work). More research on existing measures is needed, and greater funding for developing new measures of functional recovery is strongly recommended.

Keywords: schizophrenia / self-maintenance / functioning / functional capacity


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