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Patient-reported outcome measures in early psychosis: Evaluating the psychometric properties of the single-item Self-Reported Health and Self-Reported Mental Health measures in Chennai, India and Montreal, Canada
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  • Neha Nair,
  • Aarati Taksal,
  • Greeshma Mohan,
  • Thara Rangaswamy,
  • R Padmavati,
  • Norbert Schmitz,
  • Ashok Malla,
  • Srividya Iyer
Neha Nair
McGill University Department of Psychiatry
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Aarati Taksal
Douglas Mental Health University Institute
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Greeshma Mohan
Schizophrenia Research Foundation
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Thara Rangaswamy
Schizophrenia Research Foundation
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R Padmavati
Schizophrenia Research Foundation
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Norbert Schmitz
University Hospitals Tubingen
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Ashok Malla
McGill University Department of Psychiatry
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Srividya Iyer
McGill University

Corresponding Author:[email protected]

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Abstract

Aim: Patient-reported outcome measures (PROMs) provide valuable information and promote shared decision-making but are infrequently used in psychosis. Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH) are single-item PROMs in which respondents rate their health and mental health from ‘poor’ to ‘excellent’. We examined the psychometric properties of the SRH and SRMH in early intervention for psychosis contexts in Chennai, India and Montreal, Canada. Methods: Assessments were completed in Tamil/English in Chennai and French/English in Montreal. Test-retest reliability included data from 59 patients in Chennai and Montreal. Criterion validity was examined against clinician-rated measures of depression, anxiety, positive and negative symptoms, and a quality-of-life PROM for 261 patients in Chennai and Montreal. Results: SRH and SRMH had good to excellent test-retest reliability (ICC>0.63) at both sites and in English and Tamil (but not French). Results for criterion validity were mixed. Whereas in Montreal, low SRH was associated with not being in positive symptom remission, and poorer functioning and quality of life, SRH was associated only with functioning in Chennai. No associations were found for SRMH in Montreal. In Chennai, however, low SRMH was associated with not being in positive symptom remission and poorer functioning. Conclusions: Our work advances knowledge of more feasibly integrating single-item PROMs into clinical settings. Importantly, it highlights how PROMs may perform differently across languages and contexts. More critical work is needed to understand if discrepancies between PROMs and CROMs are indicative of poor validity of PROMs or “valid” differences between patient and clinician perceptions.
18 Sep 20231st Revision Received
19 Sep 2023Submission Checks Completed
19 Sep 2023Assigned to Editor
19 Sep 2023Review(s) Completed, Editorial Evaluation Pending
19 Sep 2023Reviewer(s) Assigned
19 Nov 2023Editorial Decision: Accept