Accuracy of self-assessment of real-life functioning in schizophrenia
Paola Rocca, Claudio Brasso, Cristiana Montemagni, Silvio Bellino, Alessandro Rossi, Alessandro Bertolino, Dino Gibertoni, Eugenio Aguglia, Mario Amore, Ileana Andriola, Antonello Bellomo, Paola Bucci, Antonino Buzzanca, Bernardo Carpiniello, Alessandro Cuomo, Liliana Dell’Osso, Angela Favaro, Giulia Maria Giordano, Carlo Marchesi, Palmiero Monteleone, Lucio Oldani, Maurizio Pompili, Rita Roncone, Rodolfo Rossi, Alberto Siracusano, Antonio Vita, Patrizia Zeppegno, Silvana Galderisi, Mario Maj, Paola Bozzatello, Cristina Badino, Benedetta Giordano, Piergiuseppe Di Palo, Vitalba Calia, Marco Papalino, Sergio Barlati, Giacomo Deste, Anna Ceraso, Federica Pinna, Benedetta Olivieri, Daniela Manca, Giuseppe Piegari, Francesco Brando, Luigi Giuliani, Carmen Aiello, Laura Fusar‐Poli, Carmen Concerto, Teresa Surace, Mario Altamura, Stefania Malerba, Flavia A. Padalino, Pietro Calcagno, Martino Belvederi Murri, Andrea Amerio, Francesca Pacitti, Valentina Socci, Alessia Lucaselli, Laura Giusti, Anna Salza, Donatella Ussorio, Felice Iasevoli, Carla Gramaglia, Eleonora Gambaro, E. Gattoni, Elena Tenconi, Enrico Collantoni, Paolo Meneguzzo, Paolo Ossola, Matteo Tonna, Maria Lidia Gerra, Claudia Carmassi, Barbara Carpita, Ivan Mirko Cremone, Giulio Corrivetti, Giammarco Cascino, Francesca Marciello, Roberto Brugnoli, Anna Comparelli, Valentina Corigliano, Nicoletta Girardi, Tommaso Accinni, Luca Carlone, Andrea Fagiolini, Arianna Goracci, Simone Bolognesi, Giorgio Di Lorenzo, Cinzia Niolu, Michele Ribolsi
Abstract
A consensus has not yet been reached regarding the accuracy of people with schizophrenia in self-reporting their real-life functioning. In a large (n = 618) cohort of stable, community-dwelling schizophrenia patients we sought to: (1) examine the concordance of patients' reports of their real-life functioning with the reports of their key caregiver; (2) identify which patient characteristics are associated to the differences between patients and informants. Patient-caregiver concordance of the ratings in three Specific Level of Functioning Scale (SLOF) domains (interpersonal relationships, everyday life skills, work skills) was evaluated with matched-pair t tests, the Lin's concordance correlation, Somers' D, and Bland-Altman plots with limits of agreement (LOA). Predictors of the patient-caregiver differences in SLOF ratings were assessed with a linear regression with multivariable fractional polynomials. Patients' self-evaluation of functioning was higher than caregivers' in all the evaluated domains of the SLOF and 17.6% of the patients exceeded the LOA, thus providing a self-evaluation discordant from their key caregivers. The strongest predictors of patient-caregiver discrepancies were caregivers' ratings in each SLOF domain. In clinically stable outpatients with a moderate degree of functional impairment, self-evaluation with the SLOF scale can become a useful, informative and reliable clinical tool to design a tailored rehabilitation program.