Routine outcome monitoring in anxiety disorders: diagnosis-specific versus generic assessment instruments
background Mental health institutions increasingly utilise routine outcome monitoring (rom) in order to assess treatment effectiveness. It remains unclear which instruments are more sensitive to change with regard to rom in patients with an anxiety disorder: diagnosis-specific or generic instruments.
aim To compare the sensitivity of diagnosis-specific versus generic rom-instruments in patients with an anxiety disorder.
method 160 adults with an anxiety disorder received cognitive behavioural therapy at the Altrecht Academic Anxiety Centre. Approximately half of the population also received medication. Patients completed an assessment both before and after treatment. This consisted of two generic instruments (Outcome Questionnaire (oq-45) and Brief Symptom Inventory (bsi)) and two diagnosis-specific instruments, determined by the main diagnosis.
results The differences between pre- and post-treatment assessments were generally larger for the generic bsi and diagnosis-specific instruments than for the generic oq-45.
conclusion When assessed after cognitive behavioural therapy, the (generic) bsi and diagnosis-specific instruments indicated larger progress than the oq-45. The bsi might be a relatively diagnosis-specific measure for anxiety disorders. when selecting an instrument for assessment, both the intended goal of treatment (symptom reduction or improvement in quality of life) and other reasons for assessment should be taken into consideration. The bsi or diagnosis-specific instruments are preferred if the goal is to assess the change in specific anxiety symptoms.