Spanish adaptation of the Scale to Assess Unawareness of Mental Disorder (SUMD)

Abstract

Introduction. The aim of this paper is to examine the reliability and external validity of the Spanish adaptation of the Scale to Assess Unawareness of Mental Disorder (SUMD).

Method. A translation-backtranslation of the original scale was elaborated, and a panel of professionals participated to assess conceptual equivalence and naturality.

The scale consists of 3 general items: awareness of mental disorder, awareness of the effects of medication and awareness of the social consequences of the disorder; and of 17 items related to specific symptoms, which make up two subscales: awareness and attribution. Thirty-two patients diagnosed of schizophrenic or schizoaffective disorder following DSM-IV criteria were evaluated. The evaluations were performed using interviews with an observer. Intraclass Correlation Coefficient (ICC) was calculated for the reliability analysis and the Spearman correlation coefficient between the SUMD scores and one independent score of global insight for external validity.

Results. The ICC were all over 0.70. Convergent validity with the independent global measurement of insight was found for the general items of awareness of mental disorder and awareness of the effects of medication, and for the subscale on awareness of symptoms. The awareness of the social consequences of the disorder and the subscale on attribution did not correlate significantly with the global measurement of awareness (insight). These results are consistent with the hypothesis that awareness (insight) is a multidimensional phenomenon.

Conclusion. The Spanish adaptation of the SUMD scale is conceptually equivalent and displays a similar reliability and external validity as the original version.