Validation of a European Spanish-version of the University of California performance Skills Assessment (Sp-UPSA) in patients with schizophrenia and bipolar disorder.
OBJECTIVE
To validate the Spanish version of the University of California Performance Skills Assessment (UPSA) in patients with severe mental disorders.


METHODS
Naturalistic, 6month follow-up, multicentre, validation study. 139 patients with schizophrenia, 57 bipolar patients and 31 controls were evaluated using the following scales: Spanish UPSA (Sp-UPSA), Clinical Global Impression, Severity (CGI-S), Global Assessment of Functioning (GAF), and Personal and Social Performance (PSP).


RESULTS
Reliability: Internal consistency (Cronbach's alpha) was 0.81 in schizophrenia and 0.58 in bipolar patients. Test-retest was 0.74 and 0.65 (p<0.0001) respectively. Construct validity: Pearson correlation coefficients between Sp-UPSA and PSP total scores were 0.42 (p<0.0001) for schizophrenia and 0.44 (p=0.001) for bipolar patients. For Sp-UPSA and GAF scores correlation coefficients were 0.43 and 0.52 (p<0.0001) respectively. Discriminant validity: The Sp-UPSA discriminated between patients and controls. In schizophrenia patients it also discriminated among different levels of illness severity according to CGI-S scores. In control versus patients with schizophrenia contrasts, the area under the curve was 0.89 and a cut-off point of 85 provided a sensitivity of 82.7% and a specificity of 77.4%. In bipolar patients, the area under the curve was 0.85 and a cut-off point of 90 provided a sensitivity of 82.5% and a specificity of 64.5%.


CONCLUSIONS
The Spanish UPSA is a reliable and valid instrument for assessing functional capacity in severe mentally ill patients. It seems to be appropriate for use in clinical trials and in everyday clinical practice as a means of monitoring functional outcomes.
Department of Psychiatry, University of Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
Maria P
MP
Garcia-Portilla
Jesus J
JJ
Gomar
Maria T
MT
Bobes-Bascaran
Isabel
I
Menendez-Miranda
Pilar A
PA
Saiz
Jose
J
Muñiz
Celso
C
Arango
Thomas L
TL
Patterson
Philip D
PD
Harvey
Julio
J
Bobes
Terry E
TE
Goldberg
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000209:etiology*; D011594:Psychometrics; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000150:complications*; D013030:Spain; D014175:Translating; D055815:Young Adult
Bipolar disorder; Functional capacity; Psychometric properties; Schizophrenia; Sp-UPSA