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Beyond symptom improvement: transdiagnostic and disorder-specific ways to assess functional and quality of life outcomes across mental disorders in adults

Beyond symptom improvement: transdiagnostic and disorder-specific ways to assess functional and quality of life outcomes across mental disorders in adults
Beyond symptom improvement: transdiagnostic and disorder-specific ways to assess functional and quality of life outcomes across mental disorders in adults
Improving meaningful outcomes is the main goal of clinical care for mental disorders. Traditionally, the focus in clinical research and practice has been on outcome domains that refer to symptom severity or service use (e.g., hospitalization), relate to categorical diagnoses, and favour clinician-rated measures. More recently, self-rated and dimensional as well as transdiagnostic outcome domains have gained traction, and functioning, quality of life and well-being/life satisfaction, along with the construct of personal recovery, have become a stronger focus. These key multidimensional outcome domains need to be properly defined and assessed. Further, the concepts of “functional” and “personal” recovery need to be differentiated. “Functional recovery” is defined by observed functioning across the domains of self-care, social interactions, leisure time activities, and educational or vocational activities. “Personal recovery” involves the subjective sense of living a personally meaningful life, irrespective of whether symptoms continue, or ongoing/intermittent support is needed. Despite the multi-stakeholder relevance of these outcome domains, no comprehensive account of how to measure them is available. To fill this gap, we provide here an overview of the main tools to assess functioning, quality of life/well-being/life satisfaction, and personal recovery outcomes across mental disorders in adults, aiming to also identify additional needs that should be addressed. We identified tools that can be used in clinical and research practice to assess people with the following mental health conditions: anxiety disorders, bipolar disorder, dementias, eating disorders, major depressive disorder, obsessive-compulsive and related disorders, personality disorders, post-traumatic stress disorder, schizophrenia, and substance use disorders. Both transdiagnostic and disorder-specific measures are described. Suggested tools were selected keeping feasibility and scalability needs in mind. The incorporation of these measures in both research and clinical care will enrich patient assessment as well as treatment planning and evaluation, increasing the likelihood of enhanced outcomes in people living with mental disorders.
Outcome domains, functioning, quality of life, well-being, life satisfaction, personal recovery, transdiagnostic measures, measurement-based care
2051-5545
Correll, Christoph U.
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Cortese, Samuele
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Solmi, Marco
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Boldrini, Tommaso
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Demyttenaere, Koen
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Domschke, Katharina
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Fusar-Poli, Paolo
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Gorwood, Philip A.P.M.
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Harvey, Philip D.
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Keefe, Richard S.E.
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Knaevelsrud, Christine
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Kotov, Roman
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Nohr, Laura
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Rhee, Taeho Greg
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Roe, David
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Rose, Matthias
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Schneider, Lon S.
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Slade, Mike
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Stein, Dan J.
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Sunkel, Charlene
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Mcintyre, Roger S.
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Correll, Christoph U.
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Cortese, Samuele
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Solmi, Marco
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Boldrini, Tommaso
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Demyttenaere, Koen
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Domschke, Katharina
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Fusar-Poli, Paolo
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Gorwood, Philip A.P.M.
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Harvey, Philip D.
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Keefe, Richard S.E.
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Knaevelsrud, Christine
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Kotov, Roman
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Nohr, Laura
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Rhee, Taeho Greg
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Roe, David
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Rose, Matthias
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Schneider, Lon S.
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Slade, Mike
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Stein, Dan J.
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Sunkel, Charlene
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Mcintyre, Roger S.
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Correll, Christoph U., Cortese, Samuele, Solmi, Marco, Boldrini, Tommaso, Demyttenaere, Koen, Domschke, Katharina, Fusar-Poli, Paolo, Gorwood, Philip A.P.M., Harvey, Philip D., Keefe, Richard S.E., Knaevelsrud, Christine, Kotov, Roman, Nohr, Laura, Rhee, Taeho Greg, Roe, David, Rose, Matthias, Schneider, Lon S., Slade, Mike, Stein, Dan J., Sunkel, Charlene and Mcintyre, Roger S. (2024) Beyond symptom improvement: transdiagnostic and disorder-specific ways to assess functional and quality of life outcomes across mental disorders in adults. World Psychiatry. (In Press)

Record type: Article

Abstract

Improving meaningful outcomes is the main goal of clinical care for mental disorders. Traditionally, the focus in clinical research and practice has been on outcome domains that refer to symptom severity or service use (e.g., hospitalization), relate to categorical diagnoses, and favour clinician-rated measures. More recently, self-rated and dimensional as well as transdiagnostic outcome domains have gained traction, and functioning, quality of life and well-being/life satisfaction, along with the construct of personal recovery, have become a stronger focus. These key multidimensional outcome domains need to be properly defined and assessed. Further, the concepts of “functional” and “personal” recovery need to be differentiated. “Functional recovery” is defined by observed functioning across the domains of self-care, social interactions, leisure time activities, and educational or vocational activities. “Personal recovery” involves the subjective sense of living a personally meaningful life, irrespective of whether symptoms continue, or ongoing/intermittent support is needed. Despite the multi-stakeholder relevance of these outcome domains, no comprehensive account of how to measure them is available. To fill this gap, we provide here an overview of the main tools to assess functioning, quality of life/well-being/life satisfaction, and personal recovery outcomes across mental disorders in adults, aiming to also identify additional needs that should be addressed. We identified tools that can be used in clinical and research practice to assess people with the following mental health conditions: anxiety disorders, bipolar disorder, dementias, eating disorders, major depressive disorder, obsessive-compulsive and related disorders, personality disorders, post-traumatic stress disorder, schizophrenia, and substance use disorders. Both transdiagnostic and disorder-specific measures are described. Suggested tools were selected keeping feasibility and scalability needs in mind. The incorporation of these measures in both research and clinical care will enrich patient assessment as well as treatment planning and evaluation, increasing the likelihood of enhanced outcomes in people living with mental disorders.

Text
Correll et al_WP_Beyond Symptom Improvement_accepted - Accepted Manuscript
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Accepted/In Press date: 13 November 2024
Keywords: Outcome domains, functioning, quality of life, well-being, life satisfaction, personal recovery, transdiagnostic measures, measurement-based care

Identifiers

Local EPrints ID: 496317
URI: http://eprints.soton.ac.uk/id/eprint/496317
ISSN: 2051-5545
PURE UUID: 8d4c75ac-24b2-4944-9d02-164410a3a083
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

Catalogue record

Date deposited: 11 Dec 2024 17:56
Last modified: 12 Dec 2024 02:48

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Contributors

Author: Christoph U. Correll
Author: Samuele Cortese ORCID iD
Author: Marco Solmi
Author: Tommaso Boldrini
Author: Koen Demyttenaere
Author: Katharina Domschke
Author: Paolo Fusar-Poli
Author: Philip A.P.M. Gorwood
Author: Philip D. Harvey
Author: Richard S.E. Keefe
Author: Christine Knaevelsrud
Author: Roman Kotov
Author: Laura Nohr
Author: Taeho Greg Rhee
Author: David Roe
Author: Matthias Rose
Author: Lon S. Schneider
Author: Mike Slade
Author: Dan J. Stein
Author: Charlene Sunkel
Author: Roger S. Mcintyre

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