Depression Anxiety Stress Scale-10: A Brief Measure for Routine Psychotherapy Outcome and Progress Assessment

Routine outcome measurement and progress monitoring is well established to enhance quality assurance in clinical psychology service delivery but is not widely used in routine care. A major barrier to more widespread implementation is the lack of public domain, brief, psychometrically sound outcome measures that easily integrate into clinical information systems. The current study assessed a brief 10-item version of the widely used Depression Anxiety Stress (DASS)-42 scale, which we called the Depression Anxiety Stress-10 (DASS-10) scale. In two clinical samples of adults (n = 1036, 445 men, 591 women; and n = 1084, 493 men, 591 women), the DASS-10 had a replicable two-level factor structure, which at the lower level had two factors assessing stress-anxiety and depression, which each loaded onto a superordinate psychological distress scale. The items in the distress score discriminated between a clinical sample (n = 376) and a community sample (n = 379) and were sensitive to clinical change. The measure has the potential to make routine outcome measurement and progress monitoring more cost-effective to implement than existing measures, particularly when integrated with practice management software to make administration, scoring, and use easy.

Sociodemographic and clinical characteristics in child and youth mental health; comparison of routine outcome measurements of an Australian and Dutch outpatient cohort

Routine outcome measurement (ROM) data offer unique opportunities to study treatment outcomes in clinical practice, and can help to assess the real-world impact of mental health services for children and adolescents (youth). This is illustrated by studies using naturalistic data from specialist child and adolescent mental healthcare services (CAMHS), showing the proportion of patients with reliable improvement, recovery or deterioration (Burgess et al., 2015; Wolpert et al., 2016), and revealing specific subgroups of patients with greater risk of poor outcome (Garralda et al., 2000; Lundh et al., 2013; Murphy et al., 2015; Edbrooke-Childs et al., 2017). Naturalistic data are therefore undeniably necessary in addition to data derived from randomised clinical trials, which often have limited generalisability due to strict selection criteria (Rothwell, 2005; Van Noorden et al., 2014).

A therapy-led, multidisciplinary programme for treatment-resistant functional fixed dystonia

Functional neurological disorder (FND) describes various neurological symptoms that are not explained by an organic aetiology. The condition has a poor prognosis. Despite this, there is sparse research that informs clinical interventions for FND, particularly when treating functional fixed dystonia. Our article has outlined an intervention for a patient with a treatment-resistant functional fixed dystonia that was informed by a biopsychosocial model, which aimed to rehabilitate the patient’s functional motor symptoms. This led to favourable outcomes including restoring full range of movement in the patient’s right foot and improvements in routine outcome measurement scores. The patient also described the programme as life-changing and was able to re-engage in meaningful and purposeful activities.

The meagre outcomes of HoNOS

Objective: To ask the Leginski question of an outcome measurement process. Method: Articles elicited by a literature search of ‘HoNOS’ are analysed for evidence of its value or cost effectiveness to consumers, clinicians or administrators. Results: None of the 260 studies elicited by the search attempted to assess the cost of the use of Health of the Nation Outcome Scale (HoNOS). One study investigated the effect of routine outcome measurement, finding that it failed to result in the provision of evidence-based care. One study reported positive outcomes. Conclusions: The ability of HoNOS to improve the health and social functioning of mentally ill people has not been demonstrated. The widespread use of HoNOS as a routine outcome measure is not justified by the evidence.

The clinical utility of the IRAC component of the Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP)

Aims and methodThe clinical utility of the multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) has not previously been examined. We sought to establish whether referral accuracy and ability to achieve the reason(s) for referral to our liaison service improved after incorporating the Identify and Rate the Aim of the Contact (IRAC) scale of this tool into our referral process. We carried out a retrospective analysis of electronic case notes of all appropriate referrals to the team before and after this adaption.ResultsAccuracy of referrals to our team improved from 73.8 to 93.7% following intervention. Referral requests that were fully achieved improved from 57.4 to 77.8%, and referral requests that were not achieved decreased from 26.2 to 6.4%.Clinical implicationsThe IRAC component of the FROM-LP measures what it was developed for, and thus has clinical utility supporting its widespread adoption across liaison services in the National Health Service.Declaration of interestNone.

Routine outcome measurement: recovery, quality of life and co-production

SummaryPatient-reported outcome measures (PROMs) are self-rated, but may not take in other aspects of the patient's perspective, such as the inclusion of domains that reflect service-user priorities. The clinician's view still has priority, although this situation has shifted in recent years. The Recovering Quality of Life (ReQoL) offers an advance in this area.Declaration of interestNone.