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

E. de Beurs, M. Blankers, P. Delespaul, E. van Duijn, N. Mulder, A. Nugter, W. Swildens, B.G. Tiemens, J. Theunissen, A.F.A. van Voorst, J. van Weeghel

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Abstract

Background: 
The present study investigates the suitability of various treatment outcome indicators to evaluateperformance of mental health institutions that provide care to patients with severe mental illness. Severalcategorical approaches are compared to a reference indicator (continuous outcome) using pretest-posttest data ofthe Health of Nation Outcome Scales (HoNOS). 

Methods: 
Data from 10 institutions and 3189 patients were used, comprising outcomes of the first year oftreatment by teams providing long-term care. 

Results: 
Findings revealed differences between continuous indicators (standardized pre-post difference score ESand ΔT) and categorical indicators (SEM, JTRCI, JTCS, JTRCI&CS, JTrevised) on their ranking of institutions, as well assubstantial differences among categorical indicators; the outcome according to the traditional JT approach wasmost concordant with the continuous outcome indicators. 
Conclusions: 
For research comparing group averages, a continuous outcome indicator such as ES or ΔT ispreferred, as this best preserves information from the original variable. Categorical outcomes can be used toillustrate what is accomplished in clinical terms. For categorical outcome, the classical Jacobson-Truax approach ispreferred over the more complex method of Parabiaghi et al. with eight outcome categories. The latter may bevaluable in clinical practice as it allows for a more detailed characterization of individual patients.


Original languageEnglish
Article number225
JournalBMC Psychiatry
Volume18
Issue number1
DOIs
Publication statusPublished - 2018

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