Assessing everyday functioning in schizophrenia: not all informants seem equally informative

Area of Science:

• Psychiatry and Mental Health
• Clinical Psychology
• Neuroscience

Background:

• Self-reported functioning in schizophrenia often lacks correlation with objective measures and informant reports.
• Identifying reliable informants for assessing everyday functioning in schizophrenia is critical but remains unclear.

Purpose of the Study:

• To evaluate the agreement between self-reports of functioning in schizophrenia patients and reports from friends/relatives or clinicians.
• To compare the convergence of these reports with objective measures of cognitive and functional performance.

Main Methods:

• Compared self-ratings with informant ratings (friend/relative, n=154; clinician, n=39) across 6 functional status scales for 193 schizophrenia patients.
• Correlated informant and self-reports with patient performance on neuropsychological tests and a functional capacity measure.

Main Results:

• Friend/relative reports correlated significantly with patient self-reports on 4/6 scales.
• Clinician reports correlated significantly with patient self-reports on 2/6 scales.
• Clinician reports showed stronger convergence with patient performance (4/6 functional capacity, 2/6 neuropsychological tests) than friend/relative reports (1/6).

Conclusions:

• High-contact clinicians' ratings of everyday functioning in schizophrenia are more closely aligned with objective performance measures than those of family or friends.
• Clinician assessments may offer a more valid proxy for actual functional capacity in schizophrenia compared to other informant types.