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Vol. 4. Issue 1.
Pages 9-18 (January 2011)
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Vol. 4. Issue 1.
Pages 9-18 (January 2011)
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Validation of the Spanish Personal and Social Performance scale (PSP) in outpatients with stable and unstable schizophrenia
Validación de la versión española de la escala de Funcionamiento Personal y Social en pacientes ambulatorios con esquizofrenia estable o inestable
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María Paz Garcia-Portillaa,
Corresponding author
albert@uniovi.es

Corresponding author.
, Pilar Alejandra Saiza, Manuel Bousoñoa, María Teresa Bascarana, Carlos Guzmán-Quilob, Julio Bobesa, on behalf of Spanish PSP scale validation group
a Departamento de Psiquiatría, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
b Departamento Médico, Janssen-Cilag SA, Madrid, Spain
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Abstract
Introduction

The main long-term therapeutic goals of schizophrenia should go beyond the symptoms and include the improvement of patients’ psychosocial functioning and quality of life. The aim of this study was to validate the Personal and Social Performance (PSP) scale in Spanish outpatients with schizophrenia.

Materials and methods

Naturalistic, 6-month follow-up, multicentre study. 244 patients and 76 controls were evaluated using the PSP, the Social and Occupational Functioning Assessment Scale (SOFAS), and the Clinical Global Impression–Severity (CGI-S) and Change (CGI-C) scales.

Results

Internal reliability = 0.87. Test-retest reliability = 0.98. Construct validity = 1 component that explained 73.2% of the variance. Convergent validity: Pearson correlation coefficient between PSP and SOFAS= 0.95 (p<0.0001), between PSP and CGI-S=−0.88 (p<0.0001). Discriminant validity: the PSP discriminates between patients and controls [50.3 versus 91.9, p<0.0001] and among patients with mild, moderate, and severe schizophrenia according to CGI-S scores [73 versus 56.6 versus 37.5, p<0.0001]. Area under the curve = 0.986. A cut-off point of 79 on the PSP scale provided good sensitivity (94.3%) and specificity (96.1%) for identifying patients and controls according to their level of functioning. At month 6 significant improvements (p<0.0001) were seen in PSP, SOFAS, and CGI-C scores. The PSP was sensitive to improvement; a score of very much improved in the CGI-C corresponds to a improvement of 34 points in the PSP.

Conclusion

The Spanish PSP is a reliable, valid and sensitive instrument for measuring functioning in outpatients with schizophrenia. As a brief, clinician-rated instrument, the PSP scale seems to be appropriate for use in everyday clinical practice as a mean of identifying and monitoring changes in patient's functioning.

Keywords:
PSP
Social functioning
Personalfunctioning
Schizophrenia
Psychometric properties
Resumen
Introducción

Uno de los objetivos terapéuticos principales a largo plazo en la esquizofrenia incluye la mejoría en el funcionamiento psicosocial y la calidad de vida del paciente. El objetivo de este estudio fue validar la versión española de la escala de Funcionamiento Personal y Social (PSP, del inglés Personal and Social Performance) en pacientes ambulatorios con esquizofrenia.

Material y métodos

Estudio naturalístico, de 6 meses de seguimiento, multicéntrico, en el que se evaluó a 244 pacientes ambulatorios y 76 controles con la PSP, la Escala de Evaluación del Funcionamiento Social y Ocupacional (SOFAS, del inglés Social and Occupational Functioning Assessment Scale) y la Escala de Evaluación de Gravedad de la Enfermedad (ICG-G, en sus siglas en inglés)/Impresión Clínica Global del Cambio (ICG-C).

Resultados

La consistencia interna fue de 0,87, la fiabilidad test-retest, de 0,98, y la validez de constructo, 1, componente que explicaba el 73,2% de la varianza. Validez convergente: coeficiente de correlación entre las puntuaciones PSP y SOFAS = 0,95 (p <0,0001), y entre PSP e ICG-G = –0,88 (p < 0,0001). Validez discriminante: la PSP diferenció entre pacientes y controles (50,3 frente a 91,9; p < 0,0001), y entre pacientes con esquizofrenia leve, moderada y grave en función de la puntuación en la ICG-G (73 frente a 56,6 frente a 37,5; p < 0,0001). El área bajo la curva fue de 0,986. Para un punto de corte de 79, la PSP identificó a pacientes y controles según su nivel de funcionamiento con una sensibilidad del 94,3% y una especificidad del 96,1% En el sexto mes se observaron mejorías significativas (p < 0,0001) en las puntuaciones PSP, SOFAS e ICG-C. La PSP demostró ser sensible a los cambios; una puntuación de mucha mejoría en la ICG-C correspondía a una mejoría de 34 puntos en la PSP.

Conclusión

La versión española de la PSP es un instrumento fiable, válido y sensible para medir el funcionamiento de los pacientes ambulatorios con esquizofrenia. Dada su brevedad, es un instrumento apropiado para ser utilizado en la práctica clínica cotidiana para cuantificar y controlar el funcionamiento de los pacientes.

Palabras clave:
PSP
Funcionamiento social
Funcionamiento personal
Esquizofrenia
Propiedades psicométricas
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