[How is social functioning of schizophrenics measured?].
Measuring social functioning of schizophrenics is becoming an important clinical issue in the era of community care, where persons with mental illness can live in the community. Neuro- and social-cognitive function studies on the outcome of schizophrenia focus on researching brain functioning, and social functioning is a co-primary outcome measure of intervention. In this review, the viewpoint of measuring social functioning is clarified, typical and recommended assessment scales are introduced, methods to be developed for measurement are discussed, and how to measure social functioning in clinical and research settings is summarized. The axes of classifying measures include functional capacity/real-world functioning, subjective/objective evaluation, and rating/observing behaviors. Six social functioning scales were chosen as recommended scales in the study of real-world functioning as a co-primary measure in NEMH-MATRICS. Almost all scales are objective rating with the interviewing of informants. The functional capacity or competence is evaluated in performance tasks. While the scale of processing tasks of everyday functioning (UPSA) was recommended in many studies, there is no standard for assessing social skills or social problem-solving skills, because these skills differ greatly depending on the sex, age, and culture. Intervening variables among neuro/social cognitive functioning, functional capacity, and real-world functioning are intrinsic motivation, meta-cognition, self-efficacy, expected support, and the environment and support which might decrease the association of basic cognition and the functional outcome. In a clinical setting, these intervening variables, hope and subjective evaluation of support needs, and life history regarding the previous capacity are needed as well as assessment scales to develop a plan for intervention. Objective assessment scales are useful for measuring the effects of intervention.
Department of Psychiatry, Teikyo University School of Medicine.
Emi
E
Ikebuchi
D003071:Cognition / Q000502:physiology; D006801:Humans; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012917:Social Adjustment