Background: There is a growing awareness of the importance of psychosocial factors incorporated in treatment goals in schizophrenic patients. Remission, both symptomatic and psychosocial, is now an achievable goal in a substantial proportion of patients. Thus, the development of handy tools to quantify outcomes is called for.
Objective: To develop a brief, clinician-rated scale for the assessment of psychosocial remission in schizophrenia (the Psychosocial Remission in Schizophrenia [PSRS] Scale). The scale is to match the quantification of symptomatic remission as delineated by the American Psychiatric Association task force.
Method: A "bank" of 124 questions pertaining to psychosocial remission was derived from published scales reflecting 2 domains: quality of life and activities of daily living. Psychiatrists, residents, psychiatric nurses, and community nurses were presented with the questions. All were asked to choose the 8 items they considered as reflecting the essence of psychosocial remission. Interrater reliability of the final scale version was assessed among psychiatrists.
Results: The questions' bank was reviewed by 429 mental health professionals. The 4 items found to be most frequently sanctioned in the quality-of-life domain were (a) familial relations (endorsed by 78% of participants), (b) understanding and self-awareness (46%), (c) energy (58%), and (d) interest in everyday life (38%). The 4 items sanctioned in the instrumental activities of daily living domain were (a) self-care (86%), (b) activism (65%), (c) responsibility for medications (54%), and (d) use of community services (32%). Interrater reliability among 70 psychiatrists ranged from 0.67 to 0.83.
Conclusion: The PSRS is an 8-item scale quantifying psychosocial remission in schizophrenia in a manner that complements symptomatic assessment of remission. The PSRS may be useful for both research and clinical evaluation.
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Article Synopsis
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- Among the FES group, 62.9% showed NCD after 8 weeks, significantly higher than just 1.2% in the HC group, with improvements in cognitive function noted at each follow-up.
- The results indicate that better cognitive performance in FES correlates with lower psychopathology scores, suggesting a potential link between cognitive function and overall mental health outcomes in schizophrenia.
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