Article

Evaluation of the Illness Management and Recovery Scale in schizophrenia and schizoaffective disorder.

Department of Neuroscience/Psychiatry, Uppsala University Hospital, Ing. 15, SE-75185 Uppsala, Sweden.
Schizophrenia Research (Impact Factor: 4.43). 07/2011; 132(2-3):157-64. DOI: 10.1016/j.schres.2011.07.001
Source: PubMed

ABSTRACT The aim of the present study was to evaluate the psychometric properties of the parallel client and clinician versions of the Illness Management and Recovery Scale (IMRS) developed to monitor the clients' progress in the Illness Management and Recovery (IMR) program in schizophrenia. A total of 107 study participants completed assessments of the IMRS, interview-based ratings of psychiatric symptoms, self-ratings of psychiatric symptoms, perception of recovery, and quality of life. Case managers completed the clinician version of the IMRS. Both versions of the scale demonstrated satisfactory internal reliability and strong test-retest reliability. The results also indicated convergent validity with interview-based ratings of psychiatric symptoms, self-rated symptoms, perception of recovery, and quality of life for both versions of the IMRS. These findings support the utility of the IMRS as a measure of illness self-management and recovery in clients with schizophrenia.

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    ABSTRACT: Rationale, aims and objectivesThe illness management and recovery scale-clinician version (IMRS-C) is a measure of outcomes thought to be important indicators of progress for consumers participating in illness management and recovery (IMR). Prior research has examined the psychometric properties of the IMRS-C; extant research supports certain aspects of the scale's reliability (test–retest) and validity (sensitivity to interventions). Analyses based on Rasch provide certain advantages and have not been applied to the IMRS-C.Method This study used an archival IMRS database including responses regarding 697 participants with severe mental illness from a variety of community-based settings. Rasch analyses were utilized to determine item functioning and utility of the IMRS-C.ResultsResults of Rasch analyses using the IMRS-C as one unidimensional scale were problematic. Analyses grouping items into three separate scales measuring recovery, management and biological vulnerability were more promising, but the third scale had other limitations.Conclusions Results suggest that the items included in the IMRS-C can form two screeners, one for recovery and one for management; items regarding biological vulnerability were inadequate. The assessment could be supplemented by more refined measures of coping/self-management and recovery constructs.
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    ABSTRACT: OBJECTIVE The purpose of the study was to rigorously test Illness Management and Recovery (IMR) against an active control group in a sample that included veterans. METHODS A total of 118 participants with schizophrenia spectrum disorders, 56 of whom were veterans, were recruited from a Department of Veterans Affairs medical center and a community mental health center in the same city and were randomly assigned to an IMR group (N=60) or a weekly problem-solving group intervention (N=58). Groups met weekly for nine months. Blinded assessments were conducted at baseline, nine months, and 18 months on measures of symptoms, functioning, illness self-management, medication adherence, subjective recovery experiences, and service utilization. RESULTS No significant differences were found between IMR and problem-solving groups. Participants in both groups improved significantly over time in symptom severity, illness management, and quality of life and had fewer emergency department visits. Participation rates in both interventions were low. Only 28% of consumers assigned to IMR and 17% of those assigned to the problem-solving group participated in more than half the scheduled groups, and 23% and 34%, respectively, attended no sessions. CONCLUSIONS This is the first randomized controlled trial of IMR to report negative findings. Given the inclusion of an active control group and the low participation rates, further research is needed to understand factors affecting IMR effectiveness. Increased attention may need to be paid to facilitate more active participation in IMR, such as individual follow-up with consumers and the integration of IMR with ongoing treatment.
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