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Functional Capacity and Functional Disability in Schizophrenia : A Cross-National Study in New York and Sweden
- Harvey, P. D. (author)
- Helldin, L. (author)
- Olsson, A-K. (author)
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- Patterson, T. L. (author)
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- (creator_code:org_t)
- 2008
- 2008
- English.
- Conference paper (peer-reviewed)
Abstract
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- Background: Functional disability is a central feature of schizophrenia and has been reported to occur across different countries and systems of care. Recent advances in the assessment of disability have separeted the measuremet of functional capacity: the ability to perform skills required for everyday functioning from the measurement of real-world functional outcomes. This presentation reports on a cross-national study of the correlation between functional capacity measured with the UCSD Performance-based Skills Assessment, Brief version (UPSA-B), casemanager ratings of patient everyday functioning with the Specific Levels Of Functioning (SLOF), and occurrence of real-world functional milestones, including independent living, employment, and marital status. Patients with schizophrenia who lived in an urban American setting and a generally rural region in Sweden were compared on their functional capacity performance and real-world outcomes. Metods:Samples of schizophrenia patients in Sweden (n=146) and New York (n=244) performed the UPSA-B and a neuropsychological assessment and were rated by their case managers. Information from archival records and case managers was used to determine the occurence of the different real world outcomes, including living independently and having ever experienced a stable romantic relationship.Results: Performance on the UPSA-B was essentially identical in the two patient samples, with a total raw score in the New York sample 13.8 and the score in the Swedish sample 13.8. Scores on the case manager ratings of everyday activities were also strikingly similar (New York:49; Sweden:49). Further, the correlation between UPSA-B scores and ratings of everyday activities were quite similar, New York: r=.36 Sweden: r=.27 as were the correlations between NP performance and UPSA-B scores, New York: r=.58; Sweden: r=.55. Also, the proportion of cases who had never been married or had a close relationship was 59% in New York and 64% in Sweden. In notable contrast, 80% of the Swedish patients and 46% of the New York patients were living independently.Implications: Performance-based measures of functional capacity were very similar across samples of people with schizophrenia in very different living environments. These results are consistent with previous studies showing that performance-based measures of cognition are also quite similar across different countries in people with schizophrenia. While measures of functional ability and case manager estimates of patients' real-world outcomes were very similar in level of impairment and correlational structure, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to very divergent outcomes in individuals who have evidence of the same levels of ability and potential.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
Keyword
- Psykologi
- Psychology
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- ref (subject category)
- kon (subject category)
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- Harvey, P. D.
- Helldin, L.
- Olsson, A-K.
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- Patterson, T. L.
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- SOCIAL SCIENCES
- SOCIAL SCIENCES
- and Psychology
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- Karlstad University
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