The Independent Living Scales as a Measure of Functional Outcome for Schizophrenia
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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Article: The Independent Living Scales as a Measure of Functional Outcome for Schizophrenia
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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  . The ILS is conducted by a clinician and consists of five subscales and two factor-analyzed subscales. "
ABSTRACT: This article reviews measures of Alzheimer's disease (AD) progression in relation to patient dependence and offers a unifying conceptual framework for dependence in AD. Clinicians typically characterize AD by symptomatic impairments in three domains: cognition, function, and behavior. From a patient's perspective, changes in these domains, individually and in concert, ultimately lead to increased dependence and loss of autonomy. Examples of dependence in AD range from a need for reminders (early AD) to requiring safety supervision and assistance with basic functions (late AD). Published literature has focused on the clinical domains as somewhat separate constructs and has given limited attention to the concept of patient dependence as a descriptor of AD progression. This article presents the concept of dependence on others for care needs as a potential method for translating the effect of changes in cognition, function, and behavior into a more holistic, transparent description of AD progression.Alzheimer's & dementia: the journal of the Alzheimer's Association 11/2010; 6(6):482-93. DOI:10.1016/j.jalz.2009.09.004 · 17.47 Impact Factor
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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. "
ABSTRACT: Theory of mind deficits in schizophrenia have been parsed into mental state reasoning and mental state decoding components. We report that mental state decoding as measured by the ‘Eyes task’ better predicted social function than mental state reasoning as measured by the ‘Hinting task’ in 73 out-patients with chronic schizophrenia. Mental state decoding task performance also partly mediated the influence of basic neuropsychological performance on social function. We discuss these findings in terms of the accumulating evidence that mental state decoding has particular relevance for understanding deficits in social function in schizophrenia.The British Journal of Psychiatry 08/2008; 193(1):77-8. DOI:10.1192/bjp.bp.107.044198 · 7.34 Impact Factor
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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. "
ABSTRACT: The objective of this study was to examine the sensitivity and specificity of a performance-based measure of functional capacity, the UCSD Performance-based Skills Assessment (UPSA), for the prediction of independent living status in patients with chronic schizophrenia-related conditions. A sample of 434 adults with schizophrenia or schizoaffective disorder was administered the UPSA and assessed for independent living status. Participants were classified as "independent" if they were living alone in an apartment, house, or single-resident occupancy (e.g., hotel room) and non-independent if they resided in a care facility (e.g., Board-and-Care home, Skilled Nursing Facility). Receiver Operator Characteristic (ROC) curves were calculated with the UPSA and Mattis' Dementia Rating Scale (DRS) scores as predictor variables and residential independence as the state variable. Of the 434 participants, 99 (23%) were living independently at the time of assessment. The discriminant validity of the UPSA was adequate (ROC area under the curve=0.74; 95% CI: 0.68-0.79), with greatest dichotomization for the UPSA at a cutoff score of 75 (68% accuracy, 69% sensitivity, 66% specificity), or 80 (68% accuracy, 59% sensitivity, 76% specificity). The UPSA was also a significantly better predictor of living status than was the DRS, based on ROC (z=2.43, p=.015). The UPSA is a brief measure of functional capacity that predicts the ability of patients with schizophrenia to reside independently in the community.Journal of Psychiatric Research 04/2008; 42(4):320-7. DOI:10.1016/j.jpsychires.2006.12.008 · 4.09 Impact Factor