Comparing self and clinician ratings on measures of mental health: A review of the literature and an assessment of the feasibility and utility of using the CORE-OM (Clinical Outcomes in Routine Evaluation – Outcome Measure) in secure hospitals

Abstract

Overall Abstract Literature Review: The objective was to investigate the association between self-reported and clinician-reported measures of anxiety and depression for people with a diagnosis of schizophrenia. Methods: Electronic searches were conducted via Web of Knowledge, OvidSP, and CINAHL, analysis was conducted on 10 papers. Results: All studies reported significant correlations between patient-rated and clinician-rated measures, although the strength of the correlations varied. Correlations were strongest when completed by researchers using appropriate measures. Conclusion: The review profiles the association between patient and clinician-reported measures and suggests that self-report measures can be used meaningfully with patients with a diagnosis of schizophrenia. Research Report: Government policy calls for the use of patient-reported outcome measures particularly in forensic services. Aims: This study aimed to (i) investigate the feasibility of the CORE-OM in secure hospitals, (ii) assess correlations between patient and nurse-ratings, and (iii) investigate patient responding style and the influence of insight on self-reported scores. Method: Patients completed the CORE-OM and measures of insight and social desirability (SD). Nurses completed CORE-OM (staff version) and a functioning scale. Both participated in semi-structured interviews Results: Mean scores reported by patients and nurses were lower than those previously reported in prison, clinical and non-clinical samples, although the results do not show that patient scores were influenced by insight or SD. One significant correlation between the 2 perspectives was obtained was for the functioning domain. Conclusion: Although the opinions of patients and nurses, and psychometric data suggest that the CORE-OM is acceptable and feasible within secure hospitals, the low scores are incongruent and there is the need for further research to understand this phenomenon.