Performance-based assessment of functional skills in severe mental illness

Results of a large-scale study in China

Belinda J. McIntosh, Xiang Yang Zhang, Thomas Kosten, Shu Ping Tan, Mei Hong Xiu, Jeffrey Rakofsky, Philip D Harvey

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Performance-based assessments of everyday living skills have been shown to be highly correlated with cognitive functioning in schizophrenia and bipolar disorder, as well as being predictive of deficits in real-world outcomes such as independent living and employment. In this study, we expand our assessments of impairments in everyday living skills to China, evaluating people with schizophrenia, bipolar disorder, and major depression, and comparing their performance to that of healthy controls. Samples of people with schizophrenia (n = 272), bipolar disorder (n = 61), major depression (n = 50), and healthy controls (n = 284) were examined with the Chinese version of the UCSD performance-based assessment, brief version (UPSA-B). Performance was compared across the groups and the association between age, gender, educational attainment, marital status, and UPSA-B scores was evaluated. When the performance on the UPSA was compared across the groups, with education as a covariate, significant effects of both diagnosis (F = 86.3, p <.001) and education were found (F = 228.3, p <.001). Sex and age did not contribute significantly when age and education were considered. Post-hoc comparisons revealed that total UPSA-B scores were lowest in the schizophrenia patients, followed by the patients with major depression. Patients with bipolar disorder did not differ from the healthy comparison subjects on overall performance. Scores for all groups were lower than previously reported in western samples (e.g., HC mean = 64). While diagnostic differences in UPSA-B scores are similar to those previously seen in western samples, the education effect is considerably more substantial. These data suggest that in developing countries educational attainment may be strongly associated with levels of adaptive outcomes and the utilization and interpretation of functional capacity measures be adjusted accordingly.

Original languageEnglish
Pages (from-to)1089-1094
Number of pages6
JournalJournal of Psychiatric Research
Volume45
Issue number8
DOIs
StatePublished - Aug 1 2011

Fingerprint

Bipolar Disorder
China
Schizophrenia
Education
Depression
Independent Living
Marital Status
Developing Countries
Healthy Volunteers

Keywords

  • Bipolar disorder
  • Depression
  • Functional capacity
  • Performance-based assessment
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Performance-based assessment of functional skills in severe mental illness : Results of a large-scale study in China. / McIntosh, Belinda J.; Zhang, Xiang Yang; Kosten, Thomas; Tan, Shu Ping; Xiu, Mei Hong; Rakofsky, Jeffrey; Harvey, Philip D.

In: Journal of Psychiatric Research, Vol. 45, No. 8, 01.08.2011, p. 1089-1094.

Research output: Contribution to journalArticle

McIntosh, Belinda J. ; Zhang, Xiang Yang ; Kosten, Thomas ; Tan, Shu Ping ; Xiu, Mei Hong ; Rakofsky, Jeffrey ; Harvey, Philip D. / Performance-based assessment of functional skills in severe mental illness : Results of a large-scale study in China. In: Journal of Psychiatric Research. 2011 ; Vol. 45, No. 8. pp. 1089-1094.
@article{b4a8364fcfee4dee8786622fdfea1c87,
title = "Performance-based assessment of functional skills in severe mental illness: Results of a large-scale study in China",
abstract = "Performance-based assessments of everyday living skills have been shown to be highly correlated with cognitive functioning in schizophrenia and bipolar disorder, as well as being predictive of deficits in real-world outcomes such as independent living and employment. In this study, we expand our assessments of impairments in everyday living skills to China, evaluating people with schizophrenia, bipolar disorder, and major depression, and comparing their performance to that of healthy controls. Samples of people with schizophrenia (n = 272), bipolar disorder (n = 61), major depression (n = 50), and healthy controls (n = 284) were examined with the Chinese version of the UCSD performance-based assessment, brief version (UPSA-B). Performance was compared across the groups and the association between age, gender, educational attainment, marital status, and UPSA-B scores was evaluated. When the performance on the UPSA was compared across the groups, with education as a covariate, significant effects of both diagnosis (F = 86.3, p <.001) and education were found (F = 228.3, p <.001). Sex and age did not contribute significantly when age and education were considered. Post-hoc comparisons revealed that total UPSA-B scores were lowest in the schizophrenia patients, followed by the patients with major depression. Patients with bipolar disorder did not differ from the healthy comparison subjects on overall performance. Scores for all groups were lower than previously reported in western samples (e.g., HC mean = 64). While diagnostic differences in UPSA-B scores are similar to those previously seen in western samples, the education effect is considerably more substantial. These data suggest that in developing countries educational attainment may be strongly associated with levels of adaptive outcomes and the utilization and interpretation of functional capacity measures be adjusted accordingly.",
keywords = "Bipolar disorder, Depression, Functional capacity, Performance-based assessment, Schizophrenia",
author = "McIntosh, {Belinda J.} and Zhang, {Xiang Yang} and Thomas Kosten and Tan, {Shu Ping} and Xiu, {Mei Hong} and Jeffrey Rakofsky and Harvey, {Philip D}",
year = "2011",
month = "8",
day = "1",
doi = "10.1016/j.jpsychires.2011.01.012",
language = "English",
volume = "45",
pages = "1089--1094",
journal = "Journal of Psychiatric Research",
issn = "0022-3956",
publisher = "Elsevier Limited",
number = "8",

}

TY - JOUR

T1 - Performance-based assessment of functional skills in severe mental illness

T2 - Results of a large-scale study in China

AU - McIntosh, Belinda J.

AU - Zhang, Xiang Yang

AU - Kosten, Thomas

AU - Tan, Shu Ping

AU - Xiu, Mei Hong

AU - Rakofsky, Jeffrey

AU - Harvey, Philip D

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Performance-based assessments of everyday living skills have been shown to be highly correlated with cognitive functioning in schizophrenia and bipolar disorder, as well as being predictive of deficits in real-world outcomes such as independent living and employment. In this study, we expand our assessments of impairments in everyday living skills to China, evaluating people with schizophrenia, bipolar disorder, and major depression, and comparing their performance to that of healthy controls. Samples of people with schizophrenia (n = 272), bipolar disorder (n = 61), major depression (n = 50), and healthy controls (n = 284) were examined with the Chinese version of the UCSD performance-based assessment, brief version (UPSA-B). Performance was compared across the groups and the association between age, gender, educational attainment, marital status, and UPSA-B scores was evaluated. When the performance on the UPSA was compared across the groups, with education as a covariate, significant effects of both diagnosis (F = 86.3, p <.001) and education were found (F = 228.3, p <.001). Sex and age did not contribute significantly when age and education were considered. Post-hoc comparisons revealed that total UPSA-B scores were lowest in the schizophrenia patients, followed by the patients with major depression. Patients with bipolar disorder did not differ from the healthy comparison subjects on overall performance. Scores for all groups were lower than previously reported in western samples (e.g., HC mean = 64). While diagnostic differences in UPSA-B scores are similar to those previously seen in western samples, the education effect is considerably more substantial. These data suggest that in developing countries educational attainment may be strongly associated with levels of adaptive outcomes and the utilization and interpretation of functional capacity measures be adjusted accordingly.

AB - Performance-based assessments of everyday living skills have been shown to be highly correlated with cognitive functioning in schizophrenia and bipolar disorder, as well as being predictive of deficits in real-world outcomes such as independent living and employment. In this study, we expand our assessments of impairments in everyday living skills to China, evaluating people with schizophrenia, bipolar disorder, and major depression, and comparing their performance to that of healthy controls. Samples of people with schizophrenia (n = 272), bipolar disorder (n = 61), major depression (n = 50), and healthy controls (n = 284) were examined with the Chinese version of the UCSD performance-based assessment, brief version (UPSA-B). Performance was compared across the groups and the association between age, gender, educational attainment, marital status, and UPSA-B scores was evaluated. When the performance on the UPSA was compared across the groups, with education as a covariate, significant effects of both diagnosis (F = 86.3, p <.001) and education were found (F = 228.3, p <.001). Sex and age did not contribute significantly when age and education were considered. Post-hoc comparisons revealed that total UPSA-B scores were lowest in the schizophrenia patients, followed by the patients with major depression. Patients with bipolar disorder did not differ from the healthy comparison subjects on overall performance. Scores for all groups were lower than previously reported in western samples (e.g., HC mean = 64). While diagnostic differences in UPSA-B scores are similar to those previously seen in western samples, the education effect is considerably more substantial. These data suggest that in developing countries educational attainment may be strongly associated with levels of adaptive outcomes and the utilization and interpretation of functional capacity measures be adjusted accordingly.

KW - Bipolar disorder

KW - Depression

KW - Functional capacity

KW - Performance-based assessment

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=79960600322&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960600322&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychires.2011.01.012

DO - 10.1016/j.jpsychires.2011.01.012

M3 - Article

VL - 45

SP - 1089

EP - 1094

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

SN - 0022-3956

IS - 8

ER -