Guide to selecting and interpreting outcome measures: Mental Health

The following are examples of validated mental health outcome measures that are commonly used in Australia. The list is by no means exhaustive and you are
encouraged to search for alternatives which may be more suitable for your patient. The measures listed here are readily available on the internet. If you are using
this Guide electronically and are connected to the internet, click on the underlined links to be taken to freely available online resources for that measure.

Measure Known What it What it asks How it is What a score Comments Availability
as measures about scored means
Kessler K10 K10 General Feelings of Hand scored. Under 20: likely to be K6: Six item short form with good validity Free
Kessler K10+ K10+ emotional emotional distress Simple addition well K10+: Five additional items. These ask whether the feelings
distress gives a score 20-24: likely to have a were different from usual in the last 30 days, the number of
ranging from 10 to mild mental disorder days they made the person totally unable to work or carry out
50. 25-29: likely to have normal activities, or able to do half or less than usual, the
moderate mental number of times they saw a health professional because of
Online resource for disorder the feelings, and whether physical problems were the main
Australian norms. 30 and over: highly cause of the feelings.
distressed

Depression DASS Anxiety, Symptoms and Hand scored. Each of the three scales In addition to the basic 42-item questionnaire, a short version, Free
Anxiety and depression behaviours Scores for contain 14 items, the DASS21, is available with seven items per scale.
Stress Scale and stress depression, anxiety divided into subscales Normative data for Australian adults given in manual.
scales and stress are of two to five items
(correlations calculated by with similar content.
0.5-0.7) summation.

Somatic and SPHERE Anxiety, Symptoms and Hand scored 34 items. Developed to rate the psychological and somatic symptoms Free
Psychological 34 and depression, behaviours reported by people with common mental disorders in primary
Health Report SPHERE alcohol and and other medical care settings. The instrument is best used
12 somatic to differentiate two levels (and three types) of common
problems mental disorders (patients reporting both characteristic
psychological and somatic symptoms).

Transport Accident Commission 2006. Recipients are advised that the information contained in this document may not be complete in every respect. The TAC can accept no liability on account of errors in any
statements made or data provided, within the document itself or subsequent discussions about the document and recipients must rely on their own inquiries. Neither the TAC, its employees, nor its consultants will be held
accountable for the inaccuracy of any information in this document.
 Measure Known What it What it asks How it is What a score Comments Availability
as measures about scored means
State-Trait STAI Anxiety Anxious mood, Hand scored Two separate forms for Useful in assessing cognitive symptoms of anxiety in adults Cost
Anxiety Inventory cognition, somatic state and trait anxiety - rather than using BAI or other somatic measures where
symptoms and 22 item scales chronic pain, and other medical/health problems will
behaviours confound responses. Quick to use, sensitive to change.
Determines anxiety in a specific situation and as a general
trait. 40 items. Simple to use across range of intellects (6th
grade reading level) and adapted in more than 40 languages.
Normative data for clinical patients, students and adults.

Beck Depression BDI II Depression Depressed mood, Hand scored 21 items. Intensity of Used to assess patients diagnosed as depressed and detect Cost
Inventory II (1996) cognition and depression in clinical depression among the normal population. Age range: 13 80.
somatic symptoms and normal patients Administration: Five minutes. Self-administered, or verbally
over previous two classified as minimal, by a trained administrator. Items on the new scale bring the
weeks mild, moderate or BDIII into alignment with DSMIV criteria. The new items
severe explore agitation, worthlessness and concentration difficulty
and replace items that deal with symptoms of weight loss,
changes in body image, and somatic preoccupation. Another
item on the BDI that tapped work difficulty was revised to
examine loss of energy. Also, sleep loss and appetite loss
items were revised to assess both increases and decreases in
sleep and appetite.

Alcohol Use AUDIT Alcohol risk Alcohol related Hand scored Categorises drinking at Australian norms and 20 yrs of multinational norms. Free
Disorder behaviours low, medium and high Mandated by the World Health Organisation.
Identification Test risk and dependent
levels

Post-Traumatic PCL Post- Intrusive thoughts, Hand scored There are two ways to The PTSD Checklist is a 17-item self-rating scale that Free
Stress Disorder traumatic hyper arousal, interpret the PCL: measures the severity of PTSD symptoms.
Checklist mental health avoidance Add up all the items for
a total severity score.
PTSD>50, or against
DSM linked items.

2
 Measure Known What it What it asks How it is What a score Comments Availability
as measures about scored means
Orebro Musculo- OMPQ Generic Pain, distress, Hand scored Questionnaire scores This yellow flag screening questionnaire, when completed Free
skeletal Pain chronic pain impairment and greater than 105 four to 12 weeks after musculoskeletal injury, predicts long
Screening disability and indicate that the patient term disability and failure to return to work. A cut-off score
Questionnaire collateral is at risk. of 105 has been found to predict, with 95 per cent accuracy,
perceptions The scoring method is those who will recover and, with 81 per cent accuracy, those
built into the who will have no further sick leave, in the next six months.
questionnaire.

Multidimensional MPI Generic Pain intensity, Computer scored The MPI consists of The Multidimensional Pain Inventory (MPI) is a Free
Pain Inventory chronic pain emotional distress, three sections, each comprehensive instrument for assessing a number of
cognitive and containing subscales. dimensions of the chronic pain experience, including pain
functional intensity, emotional distress, cognitive and functional
adaptation, social adaptation and social support. It is used to assess the overall
support. adjustment of chronic pain patients and the outcomes of
treatment interventions.

Health Outcomes SF-36 Most used Physical, mental Computer scored Scoring program creates The SF-36 was designed for use in clinical practice and Cost
Short Form and SF- health status and social health two summary scores: research, health policy evaluations, and general population
12 measures physical health (PCS12) surveys. The SF-36 includes one multi-item scale that
worldwide and mental health assesses eight health concepts: 1) limitations in physical
(MCS12). activities because of health problems; 2) limitations in social
activities because of physical or emotional problems; 3)
limitations in usual role activities because of physical health
problems; 4) bodily pain; 5) general mental health
(psychological distress and well-being); 6) limitations in
usual role activities because of emotional problems; 7)
vitality (energy and fatigue); and 8) general health
perceptions. The SF-12 has very sound psychometric
characteristics, and it has been shown to be sensitive to
change. It provides both physical and mental status scores,
and it includes items on the functional impact of disorders. It
has been used in a wide variety of linguistic contexts, and
Australian norms are available.

3
 Measure Known What it What it asks How it is What a score Comments Availability
as measures about scored means
Functional FLP Changes in Each scale Hand scored. Can 136 items across 12 136 items across 12 activity scales. The Functional
Limitations function due describes a be self activity scales Limitations Profile (FLP) is a British version based on the
Profile to ill health restriction in administered or same theoretical profile and psychometric properties of the
acitivity and interview Sickness Impact Profile (De Bruin, Witte, Stevens, and
respondents are administered. Diederiks, 1992). The aim is to assess changes in function
required to indicate Instructions and due to ill health. Each scale describes a restriction in acitivity Cost
whether the item examples included. and respondents are required to indicate whether the item
applies ot them applies to them "today" and is due to ill health. Can be self-
administered or interviewer administered (comes with
instructions of difference).

Coping Resources CRI Coping Forms of coping: Hand scored. 60 items. One total Used in medical settings and with clinical samples. Useful to Cost
Inventory resources physical, Four point Likert score and five help recognise those at risk and to booster coping resources,
available for emotional, social, scale. subscales. design interventions and evaluate effectiveness of programs.
people to cognitive, Efficient and valid for use across ages 14-83. Simple to use.
cope under philosophical / Normative data.
stress spiritual
Pain PCS Affective and Sick role change, Hand scored. 13 items. Three scales The PCS measures catastrophising, a thought process Free
Catastrophising cognitive pain preoccupation (rumination, characterised by an excessive focus on pain sensations
Scale respones to and often assists in magnification, (rumination, "I cant stop thinking about how much it hurts")
pain detecting trauma helpessness) with an exaggeration of threat (magnification, "something
expressed as pain serious might happen") and the self-perception of not being
worry etc. able to cope with the pain situation (helplessness, "there is
nothing I can do to reduce the pain"). The tendency to
"catastrophise" during painful stimulation contributes to more
intense pain experience, increased emotional distress,
disability and helplessness. Normative data.

Beliefs About BPCQ Beliefs about Pain locus of Hand scored. 13 item locus of control Measures beliefs in the internal or personal control of pain. Cost
Pain Control controlling control scale: Six point Likert. No normative data as yet, but scores for range of medical
Questionnaire pain Three scales: internal, samples available. Based on well known Levenson LOC
powerful others, scale. Internal consistency quite high in chronic pain and
chance. non-patient

4
References:
Blanchard, E.B., Jones-Alexander, J., Buckley, T.C., and Forneris, C.A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34, 669-673.
Hickie, I., Andrews, G., & Davenport, T. (2002). Measuring outcomes in patients with depression and anxiety. Medical Journal of Australia, 177, 205-207
Andrews, G Slade, T. Interpreting scores on the Kessler Psychological Distress Scale (K10). Australian and New Zealand Journal of Public Health: 2001; 25:6: 494-497.
Hickie IB, Davenport TA, Hadzi-Pavlovic D, et al. Development of a simple screening tool for common mental disorders in general practice. Med J Aust 2001; 175 Suppl Jul 16: S10-S17.
Kerns, R.D., Turk, D.C., and Rudy, T.E. (1985). The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain, 23, 345-356.
Linton, S.J., and Boersma, K. (2003). Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro Musculoskeletal Pain Questionnaire. Clinical
Journal of Pain, 19:80-6.
Lovibond, P.F. & Lovibond, S.H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories.
Behaviour Research and Therapy, 33, 335-343.
Skevington, 'A standardised scale to measure beliefs about controlling pain (BPCQ): a preliminary study' Psychology and Health 4 221-232, 1990.
Williams SJ. Measuring health status? A review of the sickness impact and functional limitations profiles.Health Care Anal. 1996 Nov;4(4):273-83.
Wright S, Johnston J (1995). Measures in Health Psychology: A users portfolio: Illness, symptoms, disability and recovery