Correll Christoph U, Cortese Samuele, Solmi Marco, Boldrini Tommaso, Demyttenaere Koen, Domschke Katharina, Fusar-Poli Paolo, Gorwood Philip, Harvey Philip D, Keefe Richard S E, Knaevelsrud Christine, Kotov Roman, Nohr Laura, Rhee Taeho Greg, Roe David, Rose Matthias, Schneider Lon S, Slade Mike, Stein Dan J, Sunkel Charlene, McIntyre Roger S
Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany.
Department of Psychiatry, Northwell Health, Zucker Hillside Hospital, Glen Oaks, NY, USA.
World Psychiatry. 2025 Oct;24(3):296-318. doi: 10.1002/wps.21338.
Improving meaningful outcomes is the main goal of clinical care for mental disorders. Traditionally, the focus in clinical research and practice has been on outcome domains that refer to symptom severity or service use (e.g., hospitalization), relate to categorical diagnoses, and favour clinician-rated measures. More recently, self-rated and dimensional as well as transdiagnostic outcome domains have gained traction, and functioning, quality of life and well-being/life satisfaction, along with the construct of personal recovery, have become a stronger focus. These key multidimensional outcome domains need to be properly defined and assessed. Further, the concepts of "functional" and "personal" recovery need to be differentiated. "Functional recovery" is defined by observed functioning across the domains of self-care, social interactions, leisure time activities, and educational or vocational activities. "Personal recovery" involves the subjective sense of living a personally meaningful life, irrespective of whether symptoms continue, or ongoing/intermittent support is needed. Despite the multi-stakeholder relevance of these outcome domains, no comprehensive account of how to measure them is available. To fill this gap, we provide here an overview of the main tools to assess functioning, quality of life/well-being/life satisfaction, and personal recovery outcomes across mental disorders in adults, aiming to also identify additional needs that should be addressed. We identified tools that can be used in clinical and research practice to assess people with the following mental health conditions: anxiety disorders, bipolar disorder, dementias, eating disorders, major depressive disorder, obsessive-compulsive and related disorders, personality disorders, post-traumatic stress disorder, schizophrenia, and substance use disorders. Both transdiagnostic and disorder-specific measures are described. Suggested tools were selected keeping feasibility and scalability needs in mind. The incorporation of these measures in both research and clinical care will enrich patient assessment as well as treatment planning and evaluation, increasing the likelihood of enhanced outcomes in people living with mental disorders.
改善有意义的结果是精神障碍临床护理的主要目标。传统上，临床研究和实践的重点一直是那些涉及症状严重程度或服务使用情况（如住院治疗）、与分类诊断相关且有利于临床医生评定的测量指标的结果领域。最近，自我评定、维度性以及跨诊断结果领域受到了更多关注，功能、生活质量和幸福感/生活满意度，连同个人康复的概念，已成为更突出的重点。这些关键的多维结果领域需要得到恰当定义和评估。此外，“功能”康复和“个人”康复的概念需要加以区分。“功能康复”的定义是在自我护理、社交互动、休闲活动以及教育或职业活动等领域所观察到的功能表现。“个人康复”涉及过一种个人认为有意义的生活的主观感受，无论症状是否持续，也无论是否需要持续/间歇性的支持。尽管这些结果领域与多方利益相关者都有关联，但目前尚无关于如何测量它们的全面说明。为填补这一空白，我们在此概述评估成人精神障碍患者功能、生活质量/幸福感/生活满意度以及个人康复结果的主要工具，旨在识别还应解决的其他需求。我们确定了可用于临床和研究实践中评估患有以下心理健康状况的人群的工具：焦虑症、双相情感障碍、痴呆症、饮食失调、重度抑郁症、强迫症及相关障碍、人格障碍、创伤后应激障碍、精神分裂症以及物质使用障碍。文中既描述了跨诊断测量指标，也描述了针对特定障碍的测量指标。在选择推荐工具时考虑到了可行性和可扩展性需求。将这些测量指标纳入研究和临床护理中，将丰富患者评估以及治疗计划与评估，增加改善精神障碍患者结果的可能性。
