Patient Reported Outcomes Instruments in Schizophrenia: A Review of Psychometric Properties


Background: Interest in the self-perception of patients with mental illness is increasing because of the gap between the physician and patient perceptions of symptoms and drug side effects. Schizophrenia is one of the mental illnesses that cause the greatest difficulty in understanding the various physical and psychological impacts related to both symptoms and drug treatment. Thus, several patient-reported outcomes (PRO) have been developed to get a clearer understanding of patients’ experience with their own illness and the treatment that they receive. Objective: The aim of this study was to identify all PRO questionnaires used in the evaluation of patients with schizophrenia, and to assess the quality of these questionnaires based on psychometric evidence. Methods: All PRO questionnaires used in the evaluation of patients with schizophrenia were identified using a search strategy in Pubmed, Medline, and the ISPOR website. PRO psychometric properties were extracted, and their level of validation was assessed. Results: The literature search resulted in the identification of 70 generic, mental health-specific or schizophrenia-specific instruments. These questionnaires were categorized according to measured domains. Six major domains were identified: health related quality of life (HRQoL), insight, depression/ feelings, treatment related, illness symptoms, and caregiver/family. Questionnaires measuring other dimensions were classified as other (related to personality measurement, communication between patients and clinicians and services satisfaction). The review shows that the HRQoL questionnaires demonstrate the best psychometric properties. Conclusion: The assessments of these questionnaires, based on their psychometric evidence level, will allow researchers to choose the most appropriate PRO instruments, based on the instruments’ ability to respond to the objectives of the study and on the rigor of their psychometric qualities. As schizophrenia is a multidimensional mental illness, we argue that a single PRO questionnaire is insufficient to obtain a clear understanding of the condition and treatment effects in patients with schizophrenia. Thus, we think that new PRO instruments in schizophrenia should be developed.

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A. Millier, E. Clay, I. Charaf, D. Chauhan, V. Murthy, M. Toumi and N. Cadi-Soussi, "Patient Reported Outcomes Instruments in Schizophrenia: A Review of Psychometric Properties," Open Journal of Medical Psychology, Vol. 3 No. 2, 2014, pp. 141-156. doi: 10.4236/ojmp.2014.32017.

Conflicts of Interest

The authors declare no conflicts of interest.


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