Disability in schizophrenia: Contributing factors and validated assessments

Patients with schizophrenia experience impairments in multiple domains of everyday life, including the ability to maintain social relationships, sustain employment, and live independently. These impairments typically persist after patients achieve symptom remission. Assessment of patients' functioning requires multiple information sources (such as the patient, a relative, or a case worker) and performance-based measures. Functional milestones (for example, marriage or a job) are not highly related to each other and require separate assessments. Clinicians could enhance their practice by being familiar with assessment tools, such as the University of California, San Diego, Performance-Based Skills Assessment (UPSA) and the MATRICS Consensus Cognitive Battery, which are designed to evaluate real-life skills and cognitive abilities. Although often considered together, cognitive and negative symptoms appear to have differential effects on domains of functioning and likely require separate treatment interventions. With targeted therapies and frequent contact with supportive clinicians, there is increasing evidence that patients can improve in their functioning in crucial areas that impact their quality of life.