The Brief Symptom Inventory and the Outcome Questionnaire-45 in the Assessment of the Outcome Quality of Mental Health Interventions.

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 (N = 5711) and one outpatient sample (N = 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.

[Validity of the suicidality assessment instrument PRISM-S (Pictoral Representation of Illness Self Measure - Suicidality)]. / Validierung des Suizidalitätseinschätzungsinstrumentes PRISM-S (Pictoral Representation of Illness Self Measure - Suicidality).

In routine clinical practice the assessment of suicidality proves to be difficult and complex. The aim of the present study was to examine if PRISM can be used to measure validly the person's subjectively perceived suicidality. The nonverbal visualization technique PRISM (Pictoral Representation of Illness and Self Measure) has been developed by Büchi et al. (2002) to evaluate the perceived burden of suffering due to physical illness. The adapted version of PRISM used in our study is called PRISM-S (Pictoral Representation of Illness and Self Measure - Suicidality). 156 eligible inpatients, admitted voluntarily to the crisis intervention centre Winterthur, participated in the study. We used as gold standards the well established assessment tools the Beck Scale of Suicide Ideation (BSS) and the Depressive Symptome Inventory - Subscale (DSI-SS). The results showed high correlations between PRISM-S and the BSS (r = - 0,73) and the DSI-SS scores (r = - 0,76). Clinicians, general practitioners, psychiatrists and psychologists receive with PRISM-S a valid suicidality assessment tool that is very brief and easy to administer in clinical settings.

Suicidality assessment with PRISM-S - simple, fast, and visual: a brief nonverbal method to assess suicidality in adolescent and adult patients.

BACKGROUND: The PRISM-S task was developed at the Crisis Intervention Center (KIZ) Winterthur, Switzerland, to enable an assessment of the degree of suicidality in less than 5 minutes with a simple, visual instrument. AIMS: Comparison of validity and clinical use of the new PRISM-S task with other instruments known as "gold standards". METHOD: Quantitative pilot study enlisting 100 inpatients admitted to the KIZ, aged 15-42 years. Patients' suicidality was assessed by the PRISM-S task during the first clinical interview and compared to data obtained by standardized suicidality instruments. RESULTS: The patients completed the PRISM-S task in 2 to 5 minutes without difficulty. Data show significant positive correlations between the suicidality as assessed by PRISM-S and the gold standards, i.e., DSI-SS (r = 0.59, N = 65, p < .0001). LIMITATIONS: There is no strong evidence that PRISM-S is useful for outpatients or in other settings. The experiences gained with outpatients/patients with other disorders are promising but have not been systematically evaluated. The results do not rely on a randomized design. The sample consists of persons coming to the crisis intervention center. CONCLUSIONS: PRISM-S offers a brief, easy-to-administer, and valid method to assess patients' suicidality. The simple instruction facilitates its use in other languages and other cultures as well. The acceptance by patients and health professionals was good, with no one refusing to complete the task.