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Comparison of Self-report and Clinician-rated Measures of Psychiatric Symptoms and Functioning in Predicting 1-year Hospital Readmission

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Abstract

This study compared the self-report Behavior and Symptom Identification Scale (BASIS-32) and clinician-rated Global Assessment of Functioning (GAF) in their ability to predict a measure of psychiatric outcome, 1-year psychiatric hospital readmission. BASIS-32 and GAF were completed at admission for 1034 patients in an inpatient psychiatric facility. Multiple informants analysis was used to determine the difference between the two in predicting readmission within 1 year. We also examined sensitivity, specificity, and predictive value positive of the two measures, and whether self-report added information above clinician rating in predicting outcome. While the odds of 1-year readmission decreased with increasing BASIS-32 score, there was no association between change in GAF score and 1-year readmission. Although neither measure used alone demonstrated high predictive value, using both scores improved predictive ability over using clinician rating alone. In this setting, self-report was better than clinician rating in predicting psychiatric outcome. Differences between the two in relation to other outcomes need to be examined.

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Acknowledgements

We would like to thank Thomas Idiculla and Ann Egan for their assistance with this project. This work was sponsored by National Institute of Mental Health Ruth L Kirschtein National Research Service Award Fellowship No. 5 T32 MH17119-20.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Karen M. Clements & Jane M. Murphy

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Jane M. Murphy

  3. Center for Health Quality, Outcomes & Economic Research, EN Rogers Memorial Veterans Hospital, 200 Springs Road (152), Bedford, MA, 01730, USA

    Susan V. Eisen

  4. Health Services Department, Boston University School of Public Health, Boston, MA, USA

    Susan V. Eisen

  5. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Sharon-Lise T. Normand

  6. Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Suite 302D, Boston, MA, 02115, USA

    Sharon-Lise T. Normand

  7. Massachusetts Department of Public Health, Applied Statistics, Evaluation and Technical Services, 250 Washington St., 5th floor, Boston, MA, 02108, USA

    Karen M. Clements

  8. Department of Psychiatry, Mass General Hospital-East, 13th St Rm. 9155, Charlestown, MA, 02129, USA

    Jane M. Murphy

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  1. Karen M. Clements
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Correspondence to Karen M. Clements.

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Clements, K.M., Murphy, J.M., Eisen, S.V. et al. Comparison of Self-report and Clinician-rated Measures of Psychiatric Symptoms and Functioning in Predicting 1-year Hospital Readmission. Adm Policy Ment Health 33, 568–577 (2006). https://doi.org/10.1007/s10488-006-0066-y

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  • DOI: https://doi.org/10.1007/s10488-006-0066-y

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