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
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.