The Independent Living Scales as a Measure of Functional Outcome for Schizophrenia

Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, New York, New York, United States
Psychiatric Services (Impact Factor: 2.41). 10/2004; 55(9):1052-4. DOI: 10.1176/
Source: PubMed

ABSTRACT The Independent Living Scales (ILS) measures cognitive skills required for independent living and is intended to provide guidelines for appropriate supervision requirements for persons in residential placement. To assess the validity of the ILS among persons with schizophrenia, the instrument was administered to 162 individuals with schizophrenia who were living in three gradations of care: maximum supervision, moderate supervision, and minimal supervision. Scores on the ILS differed significantly across the three levels of care, whereas scores on the Global Assessment of Functioning (GAF) that were provided by clinicians discriminated only two levels of care. The ILS can be used among patients with schizophrenia to measure cognition as it affects functional outcome.

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    • "Also, the RIL does not provide any indication of hierarchy among items; the RIL does not distinguish complex capabilities (eg, managing one's finances) that AD typically compromises early in the disease process from more basic capabilities (eg, toileting) that typically are affected later on. The Independent Living Scales (ILS) assessment was designed to provide a broad measure of dependence in patients with dementia by incorporating cognitive/reasoning skills in addition to physical measures [28] [30]. The ILS is conducted by a clinician and consists of five subscales and two factor-analyzed subscales. "
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    • "As further confirmation of these findings, and the earlier report by Bora et al,3 it may be helpful to investigate this relationship between mental state decoding and social function using multiple mental state decoding tasks within the same study design. Finally, for future studies, the ILS measure employed here, although previously validated in schizophrenia,15 is a proxy measure for social function and outcome; further theory of mind studies may benefit from more direct outcome measures. "
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    • "We believe the UPSA would perform particularly well compared to clinical assessments such as GAF scores. Previous studies have found GAF scores to be poor predictors of living status and functioning (Revheim et al., 2004a; Roy-Byrne et al., 1996) and suggest that relying on the GAF to assess patients' functioning may be problematic. Nonetheless, we recommend that future studies should compare the AUC for clinical ratings of functioning such as GAF scores to that of the UPSA. "
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