Crameri Aureliano, Schuetz Christopher, Andreae Andreas, Koemeda Margit, Schulthess Peter, Tschuschke Volker, von Wyl Agnes
Zurich University of Applied Sciences, Zurich, Switzerland.
Integrated Psychiatric Services Winterthur and Zurich Unterland (ipw), Winterthur, Switzerland.
Psychiatry J. 2016;2016:7830785. doi: 10.1155/2016/7830785. Epub 2016 Sep 8.
Self-report questionnaires are economical instruments for routine outcome assessment. In this study, the performance of the German version of the Outcome Questionnaire-45 (OQ-45) and the Brief Symptom Inventory (BSI) was evaluated when applied in analysis of the outcome quality of psychiatric and psychotherapeutic interventions. Pre-post data from two inpatient samples ( = 5711) and one outpatient sample ( = 239) were analyzed. Critical differences (reliable change index) and cut-off points between functional and dysfunctional populations were calculated using the Jacobson and Truax method of calculating clinical significance. Overall, the results indicated that the BSI was more accurate than the OQ-45 in correctly classifying patients as clinical subjects. Nonetheless, even with the BSI, about 25% of inpatients with schizophrenia attained a score at admission below the clinical cut-off. Both questionnaires exhibited the highest sensitivity to psychopathology with patients with personality disorders. When considering the differences in the prescores, both questionnaires showed the same sensitivity to change. The advantage of using these self-report measures is observed primarily in assessing outpatient psychotherapy outcome. In an inpatient setting two main problems-namely, the low response rate and the scarce sensitivity to psychopathology with severely ill patients-limit the usability of self-report questionnaires.
自我报告问卷是用于常规结果评估的经济工具。在本研究中,对德文版的结果问卷-45(OQ-45)和简明症状量表(BSI)在分析精神科和心理治疗干预的结果质量时的表现进行了评估。分析了来自两个住院样本(n = 5711)和一个门诊样本(n = 239)的前后数据。使用雅各布森和特鲁克斯计算临床意义的方法计算了功能正常和功能失调人群之间的临界差异(可靠变化指数)和临界点。总体而言,结果表明,在将患者正确分类为临床受试者方面,BSI比OQ-45更准确。尽管如此,即使使用BSI,约25%的精神分裂症住院患者入院时的得分仍低于临床临界点。两种问卷对人格障碍患者的精神病理学表现出最高的敏感性。考虑到预得分的差异,两种问卷对变化的敏感性相同。使用这些自我报告测量方法的优势主要体现在评估门诊心理治疗结果方面。在住院环境中,两个主要问题——即低应答率和对重症患者精神病理学的敏感性不足——限制了自我报告问卷的可用性。