Patient-reported outcomes in schizophrenia

Abstract

Background: Patient-reported outcomes are increasingly used to evaluate the care of people with schizophrenia. Aims: To review established and emerging patient-reported outcomes in schizophrenia research, assessment tools and key findings. Method: A non-systematic review addressing relevant constructs, the associated scales and key empirical findings. Results: Patient-reported outcomes in schizophrenia relate either to evaluation of illness and benefit from treatment or to resilience of the self. Of the former, needs for care, treatment satisfaction and the therapeutic relationship are most common. Less common are symptoms, insight, attitude towards medication, and clinical communication. Increasing expectations of treatment have led to new measures assessing resilience of the self, including empowerment, self-esteem, sense of coherence and recovery. Scores of different patient-related outcomes overlap and are influenced by a general tendency, largely influenced by mood, for more or less positive appraisal. Conclusions: The conceptual and empirical basis for different patient-reported outcomes varies, with most data available for treatment satisfaction. More than one such outcome should be used only if there is a specific hypothesis. For new patient-reported outcomes, relative independence from existing constructs should be demonstrated.