Validation of Two Outcome Measures for Routine Outcome Monitoring in Psychiatry: the HORVAN Study

Background: Transparency in psychiatry can be increased by the use of routine outcome monitoring (ROM) instruments. Instruments should be easy to use and take very little time to complete; they also need to have psychometric qualities, about interpersonal and social functioning. Aim: To investigate to what extent the Dutch translation of the combination of the Health of the Nation Outcome Scales (HoNOS) and Outcome Questionnaire (OQ) meets the above-mentioned quality criteria and to examine how the combination relates to the Symptoms CheckList (SCL-90). Method: Data for 148 patients collected at three measurement time-points were available for analysis. The psychometric qualities of the instruments and their sensitivity to change were carefully monitored. Results: The three scales showed high values for internal consistency (Cronbach's alpha). The HoNOS total score and the subscales of the OQ correlated reasonably well with the SCL-90 total score (convergent validity). At the first measurements, patients with a comorbid diagnosis had the lowest scores (discriminant validity). The clinically significant change between T1 and T2 and between T2 and T3 was sufficiently high for all measurement instruments. Conclusion: The combination of the HoNOS rating scale and the self-report list OQ seems to be suitable for ROM in psychiatry.