Schizophrenia is a major cause of disability worldwide. As new treatments for functioning are tested, the need grows to demonstrate real-world functioning gains. Ecological momentary assessment (EMA) may provide a more ecologically valid measure of functioning. In this study, smartphone-based EMA was used to signal participants with schizophrenia (N = 100) and controls (N = 71) 7 times a day for 7 days to respond to brief questionnaires about social interactions and functioning behaviors. Excellent adherence was found, with both groups completing an average of 85% of surveys and only 3% of participants with schizophrenia excluded for poor adherence. Four-week test-retest reliability was high (r = .83 for total productive behaviors). Relative to controls, participants with schizophrenia reported significantly less total productive activity (d = 1.2), fewer social interactions (d = 0.3), more nonproductive behaviors (d = 1.0; watching TV, resting), and more time at home (d = 0.8). Within the schizophrenia group, participants living independently showed better functioning on EMA relative to participants in supported housing (d = 0.8) and participants engaged in vocational activities showed better functioning than individuals not engaged in vocational activities (d = 0.55). Modest correlations were found between EMA and an in-lab self-report measure of functioning activities performed in the community, but not between EMA and measures of functional capacity or potential. This study demonstrated the feasibility, sensitivity reliability, and validity of EMA methods to assess functioning in schizophrenia. EMA provides a much-needed measure of what individuals with schizophrenia are actually doing in real-world contexts. These results also suggest that there may be important disjunctions between indices of abilities and actual real-world functioning.

中文翻译：

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精神分裂症患者整天都做什么？精神分裂症现实世界功能的生态瞬时评估。


精神分裂症是全世界残疾的主要原因。随着新的功能疗法的测试，越来越需要证明现实世界的功能增益。生态瞬时评估（EMA）可以提供更生态有效的功能衡量标准。在这项研究中，使用基于智能手机的 EMA 向精神分裂症参与者（N = 100）和对照者（N = 71）发出信号，持续 7 天每天 7 次，以回答有关社交互动和功能行为的简短调查问卷。结果显示，两组患者的依从性极佳，平均完成了 85% 的调查，只有 3% 的精神分裂症参与者因依从性差而被排除在外。四周重测可靠性很高（总体生产行为 r = 0.83）。与对照组相比，精神分裂症患者的总生产性活动显着减少 (d = 1.2)、社交互动减少 (d = 0.3)、非生产性行为增加 (d = 1.0；看电视、休息) 以及在家时间更长 (d = 1.2) 0.8）。在精神分裂症组中，独立生活的参与者相对于支持住房的参与者表现出更好的 EMA 功能（d = 0.8），而从事职业活动的参与者比不从事职业活动的参与者表现出更好的功能（d = 0.55）。 EMA 与社区中进行的功能活动的实验室自我报告测量之间存在适度的相关性，但 EMA 与功能能力或潜力的测量之间没有相关性。这项研究证明了 EMA 方法评估精神分裂症功能的可行性、敏感性、可靠性和有效性。 EMA 提供了一种急需的衡量精神分裂症患者在现实世界中实际行为的指标。 这些结果还表明，能力指数与实际的现实世界功能之间可能存在重要的脱节。