Pre-admission adaptive functioning as a measure of prognosis in psychiatric inpatients

This prospective study examined the concept of pre-admission adaptive functioning and its relationship with outcome. Pre-admission adaptive functioning was assessed by the self-report Social Adjustment Scale and the therapist rated Axis V of DSM-III. In addition, an instrument designed to look separately at the areas of interpersonal relationships, occupational functioning and use of leisure time was given to a subgroup. These measures were compared with outcome at six months as assessed by the General Health Questionnaire. Adaptive functioning proved to be a significant predictor of outcome, with the Social Adjustment Scale being a better predictor than Axis V for the whole group. In contrast, for patients with schizophrenia, the initial Axis V rating was the best predictor of the outcome score. Statistically significant correlations were found between the three areas of adaptive functioning for the group as a whole but, when examined by diagnosis, they proved to be statistically significant only in the schizophrenia sub-group, suggesting that it would be invaluable to rate the three areas separately in non-psychotic patients.