Psychometric properties of the abbreviated version of the Scale to Assess Unawareness in Mental Disorder in schizophrenia.
BACKGROUND
The Scale to Assess Unawareness in Mental Disorder (SUMD) is widely used in clinical trials and epidemiological studies but more rarely in clinical practice because of its length (74 items). In clinical practice, it is necessary to provide shorter instruments. The aim of this study was to investigate the validity and reliability of the abbreviated version of the SUMD.


METHODS



METHODS
We used data from four cross-sectional studies conducted in several psychiatric hospitals in France.


METHODS
a diagnosis of schizophrenia based on DSM-IV criteria.


METHODS
socio-demographic and clinical data (including duration of illness, Positive and Negative Syndrome Scale, and the Calgary Depression Scale); quality of life; SUMD.


METHODS
confirmatory factor analyses, item-dimension correlations, Cronbach's alpha coefficients, Rasch statistics, relationships between the SUMD and other parameters. We tested two different scoring models and considered the response 'not applicable' as '0' or as missing data.


RESULTS
Five hundred and thirty-one patients participated in this study. The 3-factor structure of the SUMD (awareness of the disease, consequences and need for treatment; awareness of positive symptoms; and awareness of negative symptoms) was confirmed using LISREL confirmatory factor analysis for the two models. Internal item consistency and reliability were satisfactory for all dimensions. External validity testing revealed that dimension scores correlated significantly with all PANSS scores, especially with the G12 item (lack of judgement and awareness). Significant associations with age, disease duration, education level, and living arrangements showed good discriminant validity.


CONCLUSIONS
The abbreviated version of the SUMD appears to be a valid and reliable instrument for measuring insight in patients with schizophrenia and may be used by clinicians to accurately assess insight in clinical settings.
Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13284 Marseille, France. laurent.boyer@ap-hm.fr.
Pierre
P
Michel
Karine
K
Baumstarck
Pascal
P
Auquier
Xavier
X
Amador
Rémy
R
Dumas
Jessica
J
Fernandez
Christophe
C
Lancon
Laurent
L
Boyer
D000328:Adult; D001364:Awareness; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires