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Translation and cross-cultural adaptation of outcome measurements for schizophrenia

EPSILON Study 2

Institute of Preventive Medicine, Copenhagen University Hospital, Denmark

JOSÉ LUIS VÁZQUEZ-BARQUERO, FRCPsych

Clinical and Social Psychiatry Research Unit, University of Cantabria, Santander, Spain

BIRGITTE WELCHER, MD

Hvidovre Hospital, Department of Psychiatry, Copenhagen, Denmark

LUIS GAITE, MD

Clinical and Social Psychiatry Research Unit, University of Cantabria, Santander, Spain

THOMAS BECKER, MD

Department of Psychiatry, University of Leipzig, Germany

DANIEL CHISHOLM, MA

Centre for the Economics of Mental Health, King's College London and London School of Economics, London, UK

MIRELLA RUGGERI, MD

Department of Medicine and Public Health, University of Verona, Italy

AART H. SCHENE, MD

Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands

GRAHAM THORNICROFT, MRCPsych, Section of Community Psychiatry (PRiSM)

Institute of Psychiatry, King's College London, UK

EPSILON STUDY GROUP

Correspondence: Dr Helle Charlotte Knudsen, Institute of Preventive Medicine, Copenhagen Hospital Corporation, Copenhagen University Hospital, 1399 Copenhagen K, Denmark. Tel: +45 333 83 888; fax: +45 333 24 240

Declaration of interest No conflict of interest. Funding detailed in Acknowledgements.

Background Research on the comparison of mental health services has identified the need for internationally standardised and reliable measurements.

Aims To describe the strategies adopted in the European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study for the translation and cross-cultural adaptation of five European versions of the instruments.

Method A protocol was developed for translation of the outcome scales, describing each step in the translation procedure. Disputed items were discussed in focus groups, which faced seven tasks: a list of topics to be discussed; chossing where the group should meet; composition of participants ; conducting the group; data collection; data completion afterwards; reporting results.

Results Modifications made to instruments were: changes in the instrument structure, contents and concepts; adjustments to the instrument structure; and modifications to the instrument manual.

Conclusion Use of focus groups is an adequate method to apply if concepts, constructs and translation issues are to be addressed; otherwise, less timeconsuming methods should be considered.

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