The "Functional Remission of General Schizophrenia" (FROGS) scale: development and validation of a new questionnaire

Functional remission is an important treatment goal in schizophrenia, as independent living and reintegration of patients into the community and the workplace is the ultimate goal of any treatment. Nevertheless, assessing functional remission in schizophrenia is problematic, as it is a multifactorial and complex entity reflecting various aspects such as symptoms severity, personal skills and socio-cultural expectancies. The purpose of this study was to create and validate a novel scale for the evaluation of functional remission in schizophrenia. Unlike previous scales, the scale was built on the basis of patients with few schizophrenia symptoms. The "Functional Remission of General Schizophrenia" (FROGS) scale was developed using the expert consensus method following a MEDLINE and standard database search. Out of the 61 initially proposed, 19 items were selected as gathering the core aspects of functional remission in schizophrenia detected in the literature. The FROGS was then evaluated in 432 patients with DSM-IV criteria of schizophrenia, all of them meeting the symptomatic remission criteria of Andreasen et al. [Andreasen, N.C., Carpenter, W.T., Kane, J.M., Lasser, R.A., Marder, S.R., Weinberger, D.R., 2005. Remission in schizophrenia: proposed criteria and rationale for consensus. Am. J. Psychiatry 162 441-449]. Total score was highly reliable. Exploratory factor analysis after oblique rotation revealed that a three-factor solution was the most meaningful. On the basis of item content these three factors were labelled 'Social Functioning,' 'Daily Life' and 'Treatment.' The FROGS total score can be used to measure a general construct for the evaluation of functional remission in schizophrenia.. Further work is required to measure the acceptability, predictive validity, sensitivity to change, and stability of the factor structure of the FROGS.