Faculty of Clinical Psychology, Leiden University, Leiden, The Netherlands.
Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
Depress Anxiety. 2019 Jan;36(1):93-102. doi: 10.1002/da.22809. Epub 2018 Sep 6.
Routine outcome monitoring (ROM) may enhance individual treatment and is also advocated as a means to compare the outcome of different treatment programs or providers. There is debate on the optimal instruments to be used for these separate tasks.
Three sets with longitudinal data from ROM were analyzed with correlational analysis and repeated measures ANOVAs, allowing for a head-to-head comparison of measures regarding their sensitivity to detect change. The responsiveness of three disorder-specific instruments, the Beck Depression Inventory, the Inventory of Depressive Symptoms, and the Mood and Anxiety Symptoms Questionnaire, was compared to three generic instruments, the Symptom Checklist (SCL-90), the Outcome Questionnaire (OQ-45), and the Brief Symptom Inventory, respectively.
In two of the three datasets, disorder-specific measures were more responsive compared to the total score on generic instruments. Subscale scores for depression embedded within generic instruments are second best and almost match disorder-specific scales in responsiveness. No evidence of a desynchronous response on outcome measures was found.
The present study compares measures head-to-had, and responsiveness is not assessed against an external criterion, such as clinical recovery.
Disorder-specific measures yield the most precise assessment for individual treatment and are recommended for clinical use. Generic measures may allow for comparisons across diagnostic groups and their embedded subscales approach the responsiveness of disorder-specific measures.
常规结果监测（ROM）可以增强个体治疗，也被提倡作为比较不同治疗方案或提供者结果的一种手段。对于这些不同的任务，使用哪种最佳的工具存在争议。
使用相关分析和重复测量方差分析对来自 ROM 的三组纵向数据进行分析，允许对不同的测量方法进行直接比较，以评估其检测变化的敏感性。比较了三种特定疾病的工具，贝克抑郁量表、抑郁症状量表和情绪和焦虑症状问卷，与三种通用工具，症状清单（SCL-90）、结果问卷（OQ-45）和简明症状量表，分别比较它们的反应能力。
在三个数据集的两个中，与通用仪器的总分数相比，特定疾病的测量方法更敏感。通用仪器中嵌入的抑郁子量表得分次之，与特定疾病的量表在反应能力上几乎相当。没有发现结果测量的不同步反应的证据。
本研究直接比较了各种测量方法，并且没有将反应能力与外部标准（如临床康复）进行比较。
特定疾病的测量方法最能精确评估个体治疗，建议在临床中使用。通用测量方法可能允许在不同诊断组之间进行比较，并且其嵌入的子量表接近特定疾病测量方法的反应能力。
