An Instrument for Measurement of Outcomes of Care for Schizophrenia

Abstract

To advance effectiveness research in mental health, we need common, standardized, validated instruments that can be used easily in routine practice settings. The Schizophrenia Outcomes Module is a relatively brief, comprehensive instrumentfor monitoring and assessing the outcomes of treatment for schizophrenia in clinical care settings. The module was developed with the guidance of a multiinstitutional, multidisciplinary expert panel; the clinical and theoretical considerations that framed the expert panel's deliberations and determined the module's content and characteristics are described Initialfield testing of the instrument involved longitudinal observation of 100 individuals with schizophrenia over a 6-month period. To our knowledge, it is the only brief and easily administered instrument that encompasses the four major outcome domains defined by the National Institute of Mental Health's Plan for Research on the Severely Mentally Ill. As such, it is a promising toolfor effectiveness research in schizophrenia.

Get full access to this article

View all access options for this article.

References

Burnam, A. , Leaf, P. J. , Skinner, E. A. , Cottler, L. , Melville, M. L. , & Thompson, J. W. (1985). Proxy interview. In W. W. Eaton & L. G. Kessler (Eds.), Epidemiologic field methods in psychiatry: The NIMHEpidemiologic CatchmentArea Program. Orlando, FL: Academic Press.

Carpenter, W. T., Jr. , & Strauss, J. S. (1991). The prediction of outcome in schizophrenia IV: Eleven-year follow-up of the Washington IPSS Cohort. Journal of Nervous and Mental Disease, 179, 517-525.

Cook, J. A. (1992). Outcome assessment in psychiatric rehabilitation services for persons with severe and persistent mental illness. Unpublished manuscript, National Institute of Mental Health.

Dworkin, R. J. (1992). Researching persons with mental illness. Newbury Park, CA: Sage.

Hargreaves, W. A. , & Shumway, M. (1989). Effectiveness of services for the severely mentally ill. InC. A. Taube , D. Mechanic , & A. Hohman (Eds.), Thefuture of the mental healthservices research (DHHS Publication No. ADM 89-1600). Washington, DC: U.S. Government Printing Office.

Heithoff, K. A. , & Lohr, K. N. (1990). Effectiveness and outcomes in health care: Proceedings of an invitational conference by the Institute of Medicine Division of Health Care Services. Washington, DC: National Academy Press.

Lehman, A. F. (1995). Quality of life and disabling mental illness: Measuring the outcomes of a changing health care system. Health Affairs, 90-101.

Lukoff, D. , Nuechterlein, K. H. , & Ventura, J. (1986). Appendix A: Manual for expanded brief psychiatric rating scale (BPRS). Schizophrenia Bulletin, 12 (4), 594-602.

McGlashan, T. H. (1986). Predictors of shorter, medium, and longer-term outcome in schizophrenia. American Journal of Psychiatry, 143 (1), 50-55.

10.

McGlashan, T. H. (1988). A selective review of recent North American long-term followup studies of schizophrenia. Schizophrenia Bulletin, 14(4), 515-542.

11.

McGlynn, E. A. (1992). A review of measures in the clinical domain for research on persons with severe and persistent mental disorders. Unpublished manuscript, National Institute of Mental Health.

12.

McLellan, A. T. , Paikh, G. , Bragg, A. , Caciola, J. , Fureman, B. , & Incrmikoski, R. (1990). Addiction severity index: Administration manual (5th ed.). Philadelphia: Pennsylvania Veterans' Administration Center for Studies of Addiction.

13.

National Institute of Mental Health . (1991). Caringfor people with severe mental disorders: A national plan of research to improve services (DDHS Publication No. ADM 91-1762). Washington, DC: U.S. Government Printing Office.

14.

Northern California Neurobehavioral Group, Inc. (1991). Manual for the neurobehavioral cognitive status examination. Fairfax, CA: Author.

15.

Nunnally, J. C. (1978). Psychometric theory (2nd ed.). New York: McGraw-Hill.

16.

Overall, J. E. , & Gorham, D. R. (1962). The brief psychiatric rating scale. Psychological Reports, 10,799-812.

17.

Rosenblatt, A. , & Attkisson, C. C. (1993). Assessing outcomes for sufferers of severe mental disorder: A conceptual frame work and review. Evaluation and Program Planning, 16,347-363.

18.

Smith, G. R. , Rost, K. M. , Fischer, E. P. , Burnam, M. A. , & Bums, B. J. (1995). Assessing the effectiveness of mental health care in routine clinical practice: Characteristics, development, and use of patient outcomes modules. Evaluation and the Health Professions, 20(1) 65-80.

19.

Spitzer, R. L. , & Williams, J.B.W. (1990). User's guide for the structured clinical interview for DSM-III-R. Washington, DC: American Psychiatric Press.

20.

Ware, J. E., Jr. , Snow, K. K. , Kosinski, M. , & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston: The Health Institute, New England Medical Center.

21.

Weissman, M. M. (1975). The assessment of social adjustment: A review of techniques. Archives of General Psychiatry, 32, 357-365.

22.

Wells, K. B. , Stewart, A. , Hays, R. D. , Burnam, A. , Rogers, W. , Daniels, M. , Berry, S. , Greenfield, S. , & Ware, J. (1989). The functioning and well-being of depressed patients: Results from the medical outcomes study. Journal of theAmerican MedicalAssociation, 262(7), 914-919.