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. 2021 Jun:47:98-111.
doi: 10.1016/j.euroneuro.2021.02.007. Epub 2021 Feb 28.

The functioning assessment short test (FAST) applied to first-episode psychosis: Psychometric properties and severity thresholds

Silvia Amoretti  1 , Gisela Mezquida  1 , Adriane R Rosa  2 , Miquel Bioque  1 , Manuel J Cuesta  3 , Laura Pina-Camacho  4 , Clemente Garcia-Rizo  1 , Fe Barcones  5 , Ana González-Pinto  6 , Jessica Merchán-Naranjo  4 , Iluminada Corripio  7 , Eduard Vieta  8 , Inmaculada Baeza  9 , Romina Cortizo  10 , C Mar Bonnín  11 , Carla Torrent  11 , Miguel Bernardo  1 ; PEPs Group
Affiliations

The functioning assessment short test (FAST) applied to first-episode psychosis: Psychometric properties and severity thresholds

Silvia Amoretti et al. Eur Neuropsychopharmacol. 2021 Jun.

Abstract

Functional impairment is a defining feature of psychotic disorders. The Functional Assessment Short Test (FAST) is one of the most widely used instruments to measure psychosocial functioning. However, cut-offs of impairment have been well-established for bipolar disorders, but not for other clinical populations. This study aims to analyse psychometric properties of the FAST and establish their corresponding cut-off values for the different severity gradations in a first-episode of non-affective psychosis (FEP) patients. Global Assessment Functioning (GAF) and FAST ratings from 212 non-affective FEP and 204 healthy controls were analyzed. The psychometric properties of FAST (internal consistency, concurrent validity, discriminant validity, factorial analyses and sensitivity to change) were analyzed. The severity gradations of the FAST were defined by the congruence between two grading methods: linear regression analysis (LRA) and percentiles. The FAST showed strong psychometric properties. LRA with the GAF scores yielded the following equation: GAFscore= 80.83 - 0.639*FASTscore. The FAST ranges in non-affective FEP patients derived from LRA and percentiles, were as follows: 0-9 (No impairment); 10-19 (Minimal impairment); 20-34 (Mild impairment); 35-45 (Moderate impairment); 46-72 (Severe impairment). Patients with no functional impairment had a higher socioeconomic status, fewer depressive and negative symptoms, lower severity of illness and higher cognitive reserve level than the others groups. In conclusion, the FAST shows optimal psychometric properties which corroborate its applicability in FEP populations. It is a well-demonstrated valid instrument and the present cut-off scores could be implemented in clinical and research practice to assess properly the psychosocial functional outcome of non-affective FEP populations.

Keywords: Early intervention; First episode; Psychometrics; Schizophrenia.

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Conflict of interest statement

Declaration of Competing Interest MBi has received honoraria from talks and consultancy of Adamed, has received honoraria from consultancy of Ferrer, has received research support and honoraria from talks and consultancy of Janssen-Cilag, has received honoraria from talks and consultancy of Lundbeck, has received honoraria from talks and consultancy of Otsuka, and a research prize from Pfizer. AG has received grants and served as consultant, advisor or CME speaker for the following entities: Almirall, AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Glaxo-Smith-Kline, Janssen-Cilag, Ferrer, Johnson & Johnson, Lundbeck, Merck, Otsuka, Pfizer, Sanofi-Aventis, Servier, Shering-Plough, Solvay, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, the Stanley Medical Research Institute, and Wyeth. EV has received grants and served as consultant, advisor or CME speaker for the following entities: Abbott, Allergan, Angelini, Dainippon Sumitomo Pharma, Janssen, Lundbeck, Novartis, Otsuka, Richter, Sage, Sanofi-Aventis, and Takeda. IB have received honoraria and travel support from Otsuka-Lundbeck and Janssen, as well as research support from the Fundación Alicia Koplowitz and grants from the Spanish Ministry of Health, Instituto de Salud Carlos III. MBe has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, AMGEN, Eli Lilly, Ferrer, Forum Pharmaceuticals, Gedeon, Janssen‐Cilag, Lundbeck, Otsuka, Pfizer and Roche. CDe-la-Camara received financial support to attend scientific meetings from Janssen-Cilag, Almirall, Eli Lilly, Lundbeck, Rovi, Esteve, Novartis, and Astrazeneca. MG has been on the speakers/advisory board of Janssen-Cilag. Dr. R. Rodriguez-Jimenez has been a consultant for, spoken in activities of, or received grants from: Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (FIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid Regional Government (S2010/ BMD-2422 AGES; S2017/BMD-3740), JanssenCilag, Lundbeck, Otsuka, Pfizer, Ferrer, Juste, Takeda, Exeltis, Casen-Recordati, Angelini. VB has been a consultant, advisor or Continuing Medical Education (CME) speaker over the last 3 years for the following entities: Angelini; Ferrer; Lundbeck; Nutrición Médica; and Otsuka. The rest of the authors report no biomedical financial interests or potential conflicts of interest.

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