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The British Journal of Psychiatry (2005) 187: 529-536
© 2005 The Royal College of Psychiatrists

Measuring outcome priorities and preferences in people with schizophrenia

Robert Rosenheck, MD

VA Northeast Program Evaluation Center, West Haven and Yale University, New Haven, Connecticut

Scott Stroup, MD, MPH

University of North Carolina, Chapel Hill, North Carolina

Richard S. E. Keefe, PhD, Joseph McEvoy, MD and Marvin Swartz, MD

Duke University, Durham, North Carolina

Diana Perkins, MD, MPH

University of North Carolina, Chapel Hill, North Carolina

John Hsiao

National Institutes of Mental Health, Bethesda, Maryland

Martha Shumway, PhD

University of California at San Francisco, San Francisco, California

Jeffrey Lieberman, MD

University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence: Dr Robert Rosenheck, Northeast Program Evaluation Center (182), VA Connecticut Health Care System, 950 Campbell Avenue, West Haven, CT 06516, USA. Tel: +1 203 937 3850; fax: +1 203 937 3433; e-mail: Robert.Rosenheck{at}Yale.edu

Declaration of interest None.

Background Measures have not taken account of the relative importance patients place on various outcomes.

Aims To construct and evaluate a multidimensional, preference-weighted mental health index.

Method Each of over 1200 patients identified the relative importance of improvement in six domains: social life, energy, work, symptoms, confusion and side-effects. A mental health index was created in which measures of well-being in these six domains were weighted for their personal importance.

Results The strongest preference was placed on reducing confusion and the least on reducing side-effects. There was no significant difference between the unweighted and preference-weighted mental health status measures and they had similar correlations with global health status measures. Patients with greater preference for functional activities such as work had less preference for medical model goals such as reducing symptoms and had less symptoms.

Conclusions A preference-weighted mental health index demonstrated no advantage over an unweighted index.


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