Treatment results for severe psychiatric illness: which method is best suited to denote the outcome of mental health care?

Edwin de Beurs*, Matthijs Blankers, Philippe Delespaul, Erik van Duijn, Niels Mulder, Annet Nugter, Wilma Swildens, Bea G. Tiemens, Jan Theunissen, Arno F. A. van Voorst, Jaap van Weeghel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: The present study investigates the suitability of various treatment outcome indicators to evaluate performance of mental health institutions that provide care to patients with severe mental illness. Several categorical approaches are compared to a reference indicator (continuous outcome) using pretest-posttest data of the Health of Nation Outcome Scales (HoNOS). Methods: Data from 10 institutions and 3189 patients were used, comprising outcomes of the first year of treatment by teams providing long-term care. Results: Findings revealed differences between continuous indicators (standardized pre-post difference score ES and Delta T) and categorical indicators (SEM, JT(RCI), JT(CS), JT(RCI&CS), JT(revised)) on their ranking of institutions, as well as substantial differences among categorical indicators; the outcome according to the traditional JT approach was most concordant with the continuous outcome indicators. Conclusions: For research comparing group averages, a continuous outcome indicator such as ES or Delta T is preferred, as this best preserves information from the original variable. Categorical outcomes can be used to illustrate what is accomplished in clinical terms. For categorical outcome, the classical Jacobson-Truax approach is preferred over the more complex method of Parabiaghi et al. with eight outcome categories. The latter may be valuable in clinical practice as it allows for a more detailed characterization of individual patients.
Original languageEnglish
Article number225
Number of pages10
JournalBMC Psychiatry
Volume18
DOIs
Publication statusPublished - 13 Jul 2018

Keywords

  • Clinical significance
  • HoNOS
  • Routine outcome monitoring
  • Severe mental illness
  • Treatment outcome
  • CLINICALLY SIGNIFICANT CHANGE
  • RELIABLE CHANGE
  • SCALES HONOS
  • PSYCHOTHERAPY
  • RELIABILITY
  • MANAGEMENT
  • SERVICES
  • VALIDITY

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