Direct assessment of functional abilities: relevance to persons with schizophrenia

Objective: To review functional outcome assessment strategies specifically focusing on performance-based measures used in patients with schizophrenia. Method: In order to identify relevant performance-based measures of functioning we conducted a literature search using key words: functioning, disability, performance, situation, assessment, skills, scale, measurement, instrument, psychosis, and schizophrenia. Results: A description of each of eight measures was provided including assessment protocol, domains of functioning assessed, scoring, basic psychometric properties, appropriateness for clinical trials and likely sensitivity to pharmacologic interventions. Methods for assessment of functioning in patients with schizophrenia are reviewed. Conclusions: The measurement of functional capacity, through performance-based activities, provides a critical benchmark by which to evaluate the efficacy and effectiveness of medications in clinical trials to improve both cognition and capacity for everyday functioning in seriously mentally ill persons with schizophrenia. In order to comprehensively evaluate functional outcome, a combination of performance-based and other assessment modalities may be required. (C) 2004 Elsevier B.V. All rights reserved.