The National Institute of Mental Health (NIMH) has awarded researchers $3.4 million over five years for a clinical study aimed at more accurately assessing real-world abilities in those with schizophrenia.
Philip Harvey, PhD, professor of psychiatry and behavioral sciences at Emory University School of Medicine, will collaborate on the study with Thomas Patterson, PhD, of the University of California, San Diego.
Schizophrenia is a chronic brain disorder that affects about 1 percent of Americans. People with schizophrenia may hear nonexistent voices, or they may believe that others are reading their minds, controlling their thoughts, or plotting to harm them. Those with schizophrenia may face a lower quality of life, difficulties caring for themselves, and the inability to hold a job. Often their families and society are adversely affected as well.
Previous research has found that those with schizophrenia inaccurately assess how well they perform day-to-day activities. In contrast, those who know a patient well, such as friends, relatives or physicians, usually give a more accurate assessment of functionality. Precise assessments are important because they play a crucial role in finding effective treatments for schizophrenia.
Harvey and Patterson will focus on three fundamental areas. First they will determine which existing methods of measuring participants' skills are most accurate for evaluating patients' ability to succeed at everyday tasks, such as the ability to hold a job or to form interpersonal relationships. They also will determine the type of informant best suited to provide accurate data on real-life outcomes in those with schizophrenia. Third, they will determine what makes those with schizophrenia so poor at self-assessment.
"There is essentially zero correlation between what a person with schizophrenia tells you about their functioning and what an observer who knows them well will tell you," says Harvey, who also directs the Emory Department of Psychiatry and Behavioral Science's schizophrenia clinical trials program. "But if you ask the right informant, such as an informed relative or case manager, you'll find that their report of how disabled a patient is correlates highly with the patient's ability to perform everyday living skills."
Currently, physicians often predict functionality through self-reports of outcomes, which tend to be inaccurate. Further, current treatment efforts are aimed at improvement of cognitive functioning and not necessarily at real-world performance, says Harvey.
The researchers anticipate that their findings will help with the development of more effective treatments for the disease by increasing the accuracy of assessment of improvements in everyday functioning with newly developed treatments.
The researchers will study 200 participants for three months each. Several informants also will assess each participant's real-world abilities.
Harvey joined Emory University School of Medicine last year after serving as professor of psychiatry at Mt. Sinai School of Medicine in New York City. He received his PhD from the State University of New York at Stony Brook and completed a clinical psychology internship at Stony Brook Psychology Training Clinic.