Functioning in schizophrenia from the perspective of psychologists: A worldwide study

Schizophrenia is a severe mental disorder associated with impairment in functioning. A multidisciplinary approach is essential to help individuals with this health condition, and psychological interventions are considered a priority. The International Classification of Functioning, Disability and Health (ICF) offers a theoretical framework for assessing functioning and disability. The ICF Core Sets for schizophrenia are a list of ICF categories describing the most common problems in functioning of persons affected by this health condition. This study aimed to explore the content validity of these ICF Core Sets and to identify the most common problems in people with schizophrenia from the perspective of psychologists. Psychologists with experience of schizophrenia treatment were recruited for a three-round Delphi study in order to gather their views regarding the problems commonly presented by these patients. A total of 175 psychologists from 46 countries covering the six WHO regions answered the first-round questionnaire, and 137 completed all three rounds. The 7,526 concepts extracted from first-round responses were linked to 412 ICF categories and 53 personal factors. Consensus (≥75% agreement) was reached for 76 ICF categories and 28 personal factors. Seventy-three of the 97 ICF categories that form the Comprehensive ICF Core Set for schizophrenia achieved consensus, and only three categories that yielded consensus do not feature in this Core Set. These results support the content validity of these ICF Core Sets from the perspective of psychologists. This provides further evidence of the suitability of the ICF framework for describing functioning and disability in persons with schizophrenia.精神分裂症（Schizophrenia）是一种以功能受损为特征的重型精神障碍。针对该疾病患者的诊疗与照护需采用多学科协作模式，而心理干预被视为核心优先干预措施。《国际功能、残疾和健康分类》（International Classification of Functioning, Disability and Health，ICF）为功能与残疾的评估提供了理论框架。精神分裂症ICF核心组合（ICF Core Sets for schizophrenia）是一系列ICF类目，用于描述该疾病患者最常见的功能问题。本研究旨在探究此类精神分裂症ICF核心组合的内容效度，并从心理学家的视角识别精神分裂症患者的常见功能问题。研究招募了具备精神分裂症诊疗经验的心理学家，开展三轮德尔菲研究（Delphi study）以收集他们关于此类患者常见临床问题的见解。最终共有来自覆盖世界卫生组织（World Health Organization，WHO）6个区域的46个国家的175名心理学家完成了首轮问卷，其中137名完成了全部三轮调研。从首轮调研应答中提取的7526个概念，被映射至412个ICF类目与53项个人因素维度。最终有76个ICF类目与28项个人因素达成≥75%的共识阈值。构成精神分裂症ICF综合核心组合的97个类目中，有73个达成共识；另有3个达成共识的类目未被纳入该综合核心组合。上述结果从心理学家的视角验证了精神分裂症ICF核心组合的内容效度，进一步证实了ICF框架可适用于描述精神分裂症患者的功能状态与残疾情况。