A review of instruments for measuring functional recovery in those diagnosed with psychosis

Schizophr Bull. 2009 Mar;35(2):307-18. doi: 10.1093/schbul/sbn152. Epub 2008 Nov 20.


The task of judging an individual's functional recovery is not an easy one for healthcare professionals. Indeed, increasing one's accuracy in predicting one's ability to self-maintain would be of great value for determining if functional recovery has or is occurring. The purpose of this review is to examine existing measures for assessing remission/normalization of functional status among people with psychosis. Our review evaluates 8 measures of functional ability encompassing self-report, clinical, and performance-based measures. We elected to utilize a grading system to aid readers in understanding the merit of a scale for use in assessing functional recovery. In this approach, a letter grade (A, B, or C) was assigned to each of 4 domains we deemed important to professionals in electing to use specific assessments: (1) Ease of Administration, (2) Reliability, (3) Validity/Relationship to Real-World Outcomes, and (4) Sensitivity to Change/Use in Clinical Trials. Results indicated that no "gold standard" measure has been developed to date, but performance-based measures appear to have the most evidence for predicting concurrent self-maintenance abilities (eg, residing independently or maintaining work). More research on existing measures is needed, and greater funding for developing new measures of functional recovery is strongly recommended.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Employment
  • Health Status
  • Outcome Assessment, Health Care / methods*
  • Outcome Assessment, Health Care / statistics & numerical data
  • Prognosis
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Schizophrenia / diagnosis*
  • Schizophrenic Psychology
  • Severity of Illness Index
  • Social Adjustment
  • Surveys and Questionnaires