People living with psychotic illness 2010

Appendix 6. Functioning and impairment

Page last updated: November 2011

The Multidimensional Scale of Independent Functioning9 was used to make global ratings of participants' level of functioning over the past four weeks. The Multidimensional Scale of Independent Functioning focuses on role performance in the home, at work (broadly defined to include employment, childcare and caring) and in study. Its subscales rate: level of role responsibility; degree of support; quality of performance for the level of responsibility and degree of support ('tolerated' or supported performance); and global functioning, correcting for support and performance. The latter provides a score of independent functioning relative to community norms.

Appendix Table 6-1. Premorbid functioning

Males
Proportion (%)
Females
Proportion (%)
Age 18-34 years
Proportion (%)
Age 35-64 years
Proportion (%)
Persons
Proportion (%)
Employed* or studying at onset
69.5
72.8
70.0
71.4
70.8
Good work* adjustment before onset
66.1
72.5
62.6
73.2
68.7
Good social adjustment before onset
63.1
65.2
64.4
63.6
63.9

*Broadly defined to include paid and unpaid work and full-time home duties

Appendix Table 6-2. Level of impairment

Males Proportion (%)Females Proportion (%)Age 18-34 years Proportion (%)Age 35-64 years Proportion (%)Persons
Proportion (%)
Deterioration from pre-onset level of functioning
92.1
87.9
87.5
92.6
90.4
Obvious/severe dysfunction in socialising, past year
64.8
61.0
59.0
66.3
63.2
Obvious/severe dysfunction in self care, past 4 weeks
35.9
27.1
27.2
36.1
32.3

Appendix Table 6-3. Global supported performance9 in past 4 weeks

Age of onset (years)Males
Proportion (%)
Females
Proportion (%)
Age 18-34 years
Proportion (%)
Age 35-64 years
Proportion (%)
Persons
Proportion (%)
No deficits
18.4
22.5
21.2
19.2
20.1
Minimal deficits
27.3
27.2
27.7
27.0
27.3
Modest but definite deficits
29.7
30.4
29.0
30.7
30.0
Moderate deficits
12.5
11.8
11.5
12.7
12.2
Significant deficits
6.3
4.9
6.1
5.5
5.8
Severe deficits
2.9
1.5
2.1
2.6
2.4
Extremely severe deficits
2.8
1.8
2.5
2.3
2.4
Total respondents
1,087
738
773
1,052
1,825

No or minimal deficits: normal performance or performance with only mild deficits.
Modest but definite deficits: clear deficits but performance is still minimally acceptable.
Moderate deficits: clear deficits but performance is no longer acceptable.
Significant deficits: severe deficits with responsibilities completed poorly and with difficulty.
Severe deficits: deficits so severe that responsibilities are rarely completed or of unacceptable quality.
Extremely severe deficits: responsibilities are completely neglected.

Appendix Table 6-4. Global independent functioning9 in past 4 weeks

Age of onset (years)Males
Proportion (%)
Females
Proportion (%)
Age 18-34 years
Proportion (%)
Age 35-64 years
Proportion (%)
Persons
Proportion (%)
Normal
4.4
7.7
7.4
4.6
5.8
Very mild disability
14.3
24.1
18.9
17.8
18.2
Somewhat disabled
23.5
29.1
25.0
26.3
25.8
Moderately disabled
30.6
22.9
25.7
28.8
27.5
Significantly disabled
19.5
12.7
17.6
16.2
16.8
Extremely disabled
6.8
1.9
4.1
5.3
4.8
Totally disabled
0.9
1.5
1.3
1.0
1.2
Total respondents
1,087
738
773
1,052
1,825

Very mild disability: functioning at the low end of the normal range but with no or minimal support.
Somewhat disabled: functioning adequately with some support or with some difficulty but no support.
Moderately disabled: functioning with significant difficulty with no supports or with some difficulty in spite of regular supports in mainstream environment.
Significantly disabled: generally unable to function at all without supports, functioning with significant difficulty even with significant supports in mainstream environment and with some difficulty in non mainstream environment.
Extremely disabled: generally not able to function in mainstream environments even with supports, functioning with significant difficulty in non mainstream environment ,functioning well and showing some independent functioning in comprehensive care environment (e.g. hospital).
Totally disabled: virtually total care provided in institutional environment with no independent functioning.

Appendix Table 6-5. Personal and Social Performance Scale10 in past year

Age of onset (years)Males
Proportion (%)
Females
Proportion (%)
Age 18-34 years
Proportion (%)
Age 35-64 years
Proportion (%)
Persons Proportion (%)
Absence of disability or only mild difficulties
13.7
23.6
19.3
16.5
17.7
Varying degrees of disability
80.7
72.5
75.8
78.5
77.4
Poor functioning sufficient to require intensive support and supervision
5.6
3.9
4.9
4.9
4.9
Total respondents
1,087
738
773
1,052
1,825