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.
I cooked a two inch ribeye steak to medium rare on the first try last night. Put a beautiful crust on the outside and kept it pink on the inside. Most neurotypicals can’t do that.
I function well enough by my own standards, thank you.
My disagreement with Psychiatry, is that they tend to put all emphasis on how it looks from the outside, when they are not living it on the inside.
There is a tendency to disempower the patient, by telling them that they are only valid through outside opinion.
I agree, when your brain is scrambled as it is at the outset of schizophrenia, you are not able to self-analyze. But if you are stable and functioning, chances are you have much more insight into your condition than anyone could ever have from the outside looking in.
I have had extremely negative experiences with psychiatrists.
I’ve been a caregiver for Phil, physical reasons. To me it seems more important.