Outcomes and indicators, measurement tools and databases for the national action plan for promotion, prevention and early intervention for mental health 2000

Mental health and psychological wellbeing - adults

Page last updated: 2002

Mental Health Inventory (MHI)
Brief Symptom Inventory (BSI)
Composite International Diagnostic Interview (CIDI)
Diagnostic Interview Scale (DIS)
Symptom Checklist— 90 Revised (SCL-90)
General Health Questionnaire (GHQ)
Short Form-36 Health Survey Questionnaire (SF-36)
Health of the Nation Outcome Scales (HoNOS)
Life Skills Profile (LSP)
Global Assessment Scale (GAS) and Global Assessment of Functioning Scale

Mental Health Inventory (MHI)A

Reference

Viet & Ware, 1983

Description

  • Type: Self-rated questionnaire rated on 6- point scale.
  • Content: 38 items, 6 sub-scales: anxiety, depression, behavioural/emotional control, general positive affect, emotional ties, life satisfaction. Also provides a global mental health index. Other versions: MHI-18, same sub-scales as MHI-38; MHI-5

Practicality

  • Range: Adult
  • Time: 5–30 mins depending upon knowledge of patient; covers past month
  • Application: Mental health & general population surveys

Reliability

  • Internal: Highly acceptable
  • Test-retest: Acceptable

Validity

  • Content: Acceptable
  • Construct: Acceptable

Norms & sensitivity

  • Sensitivity to clinical change: Yes
  • Cultural norms: Yes

Brief Symptom Inventory (BSI)

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Reference

Derogatis & Spencer 1982

Description

  • Type: Self-report measure
  • Content: 53 items rated on a 5-point scale of distress; based on symptom checklist: somatisation, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism; 3 indexes—global severity, positive symptom total, positive symptom distress index

Practicality

  • Time: 8–10 mins. Computer software available
  • Application: Mental health and non-patient (general) population
  • Use: Clinical assessment where minimal time available; screening and treatment evaluation; research

Reliability

  • Internal: Acceptable
  • Test-retest: Acceptable

Validity

  • Content: Highly acceptable
  • Construct: Highly acceptable

Norms & sensitivity

  • Sensitivity to clinical change: Yes

Composite International Diagnostic Interview (CIDI)

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Reference

Robins et al. 1988

Description

  • Type: Structured diagnostic instrument. Self-administered computerised form available.

Practicality

  • Range: 15–65 years
  • Time: Approx 15 mins
  • Application & use: Epidemiological and clinical research

Reliability

  • Internal: Highly acceptable
  • Test-retest: Highly acceptable

Validity

Validated in several cultural settings and countries
  • Concurrent: Acceptable

Norms & sensitivity

  • Cultural use: Yes. Data available for Australian populations
  • Sensitivity: Adequate
  • Specificity: High

Diagnostic Interview Scale (DIS)

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Reference

Robins et al. 1981

Description

  • Type: Structured lay-administered instrument designed for community studies
  • Content: A number of sub-scales related to psychiatric disorder (DSM-III-R definitions)

Practicality

  • Range: Adult
  • Time: 30-60 minutes
  • Training: Lay-interviewers
  • Application & use: Population screening and monitoring; clinical and research

Reliability

  • Inter-rater: Highly acceptable
  • Test-retest: Highly acceptable

Validity

Validated in a number of cultural settings and countries
  • Concurrent: Acceptable

Norms & sensitivity

  • Cultural use: Yes
  • Specificity: High
  • Sensitivity: Low

Symptom Checklist— 90 Revised (SCL-90)A

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Reference

Derogatis, Lipman & Covi 1973

Description

  • Type: Self-rated questionnaire rated on 5- point scale of distress. Covers past week
  • Content: 90 items, with 9 primary symptom dimensions: somatisation, obsessive-compulsive, inter-personal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism. 3 indices: global severity index, positive symptom distress index, positive symptom total

Practicality

  • Range: Adolescent and adult
  • Time: 10–20 mins
  • Application: Mental health & primary health
  • Use: Clinical research

Reliability

  • Item: Acceptable
  • Test-retest: Highly acceptable

Validity

  • Construct: Highly acceptable
  • Criterion: Acceptable

Norms & sensitivity

Sensitive to clinical change

General Health Questionnaire (GHQ)

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Reference

Goldberg, 1972; Goldberg, 1978

Description

  • Type: Self-administered and clinician-rated semi-structured interview; 7-point rating scale with behavioural anchors.
  • Versions: GHQ-60, GHQ-30, GHQ-28, and GHQ-12.
  • Content: 2 major areas: inability to carry out normal functions and appearance of new and distressing phenomena. 4 versions: GHQ-60, GHQ-30, GHQ-28 & GHQ-12. GHQ-28 is intended for studies where more information is needed than provided by a single severity score. It includes 4 scales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression.

Practicality

  • Range: Adolescent to adult
  • Admin:
    • GHQ-60, 6–8 mins;
    • GHQ- 30 & 28, 3–4 mins
  • Training: Minimal; not restricted to psychologists
  • Application: Mental health; clinical research survey

Reliability

  • Internal: Highly acceptable
  • Test-retest: Acceptable

Validity

  • Content: Highly acceptable
  • Construct: Highly acceptable
  • Criterion: Acceptable

Norms & sensitivity

Sensitive to clinical change
  • Cultural sensitivity: Yes
  • Cultural norms: Yes. Data available for Australian populations

Short Form-36 Health Survey Questionnaire (SF-36)A

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Reference

Ware et al. 1993

Description

  • Type: Self-administered. 2 versions: one covers past 4 weeks, other covers past week. Brief accompanying version: depression screener based on Rand items (Short Form-36-D)
  • Content: 36 items, 8 dimensions: physical and social functioning, role limitations due to physical problems, role limitations due to emotional problems, mental health, energy/ vitality, pain, general health perception, and single item about perception of health changes over past 12 months.

Practicality

  • Range: Adolescent to adult
  • Time: 5–10 mins
  • Application: Subjective health status of mental and non-clinical populations; clinical and population-based research

Reliability

  • Item: Acceptable
  • Test-retest: Acceptable

Validity

  • Content: Highly acceptable
  • Construct: Highly acceptable
  • Criterion: Acceptable

Norms & sensitivity

  • Cultural sensitivity: Yes—used worldwide; different version used in UK Australian norms— see Stevenson 1995
  • Developmental norms: Yes. Possible problems with clients over 65 years

Health of the Nation Outcome Scales (HoNOS)A

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Reference

Wing, Curtis & Beevor 1996

Description

Measures the current health and social functioning of people with a mental illness. Developed as a routine measure of consumer outcomes.
  • Type: Clinician-rated rating scale. Consumer self-report version is also available.
  • Content: 12 items, 5-point severity rating scale. There are four sub-scale scores: behaviour, impairment, symptoms and social skills.

Practicality

  • Range: Adult
  • Time: Approx 5–15 min
  • Admin: Individual
  • Training: Required, training package available
  • Application: Determine effectiveness of mental health services and clinical practice

Reliability

  • Internal: Unacceptable
  • Test-retest: Varies across items from unacceptable to barely acceptable.
  • Inter-rater reliability:Varies across items and sub-scales from unacceptable to acceptable.

Validity

  • Construct: Acceptable
  • Discriminative: Acceptable

Norms & sensitivity

Life Skills Profile (LSP)A

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Reference

Rosen, Hadzi- Pavlovic & Parker 1989

Description

Intended to measure function and disability in people with severe mental illnesses.
  • Type: Questionnaire completed by service providers, family member or carer.
  • Content: 39 items, 4-point scale. (Also available in 20-item and 16-item scale versions)Five sub-scales include self-care, non-turbulence, social contact, communication and responsibility.

Practicality

  • Range: Adult
  • Time: Approx 15 mins
  • Admin: Individual
  • Training: Designed for use by mental health professional and non-professional raters. No special training.
  • Application & use: Used to assess service delivery and consumer outcomes

Reliability

  • Internal: Range from barely acceptable to acceptable
  • Inter-rater: Barely acceptable (~0.70 for total score; between 0.41 and 0.75 for subscales)
  • Test-retest: Acceptable

Validity

  • Construct: Acceptable
  • Discriminative: 89% accuracy in matching transition between hospital and community

Norms & sensitivity

  • Cultural norms: Yes
  • Sensitive to change: Yes

Global Assessment Scale (GAS) and Global Assessment of Functioning Scale

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Reference

GAS - Endicott, Spitzer & Fleiss 1976; Global Assessment of Functioning Scale - American Psychiatric Association 1994

Description

A measure of overall severity of psychiatric disturbance.
  • Type: Clinician-rated scale based on all information available to the clinician.
  • Content: One rating required, on a scale ranging from 1 to 100 with 10-point increments.

Practicality

  • Range: Adult
  • Application & use: Summary statement, assess treatment progress, augment other measures

Reliability

  • Internal: Acceptable
  • Inter-rater: Acceptable

Validity

  • Construct: Significant correlation with measures of social and occupational functioning. Variable levels reported across different studies.

Norms & sensitivity

  • Convergent/discriminative: Unacceptable to acceptable. Findings vary across different studies

Footnotes

A Reviewed by Andrews 1994