[Study of selected methods of self-assessment of health, quality of life and satisfaction with treatment. Use among patients four weeks after discharge from a psychiatric ward]. / Undersøgelse af udvalgte metoder til selvvurdering af helbred, livskvalitet og tilfredshed med behandling. Anvendelse til patienter fire uger efter udskrivning fra psykiatrisk indlaeggelse.

INTRODUCTION: The purpose of the investigation was to test selected methods for self-evaluation of health, the quality of life, and satisfaction with treatment. As part of this, to test their fitness as quality estimates in a psychiatric ward. MATERIAL AND METHODS: Four weeks after discharge questionnaires were sent to all patients and they were asked to participate. The methods used were SF-36 (short-form-36 questions), SIP (sickness impact profile), WHO-5, and a scale measuring patient satisfaction with treatment and care. RESULTS: The response rate was almost 50%. Seventy-five per cent were feeling better or the same as they did one year before admission. Compared with average values in a healthy Danish population, the psychic health of the patients was much lower, as evaluated by the SF-36 and WHO-5. The functional level measured by the SIP was reduced 12-32% from the optimum. About 75% of the patients rated the treatment and care positively. DISCUSSION: The applied methods of self-evaluation of health, quality of life, and satisfaction with treatment were found to be appropriate. For one year, it was possible to obtain and register important data from participating patients without using too many resources. Nevertheless, only 50% answered the questionnaire. It would be desirable to simplify the necessary questionnaires, thus encouraging more patients to respond. From the agreement between the methods, the use of the SF-36, WHO-5, and the satisfaction scale would be sufficient to obtain a qualified measure of the patients' health, quality of life, and satisfaction with treatment and care. Time spent on answering could be reduced to about 20 minutes. Resources spent on registration would be so small that the methods could be used for on-line quality surveillance.

[Self assessment of the functional level in a group of psychiatric patients on admission and discharge. Aspects of the reliability of the Sickness Impact Profile]. / Selvvurdering af funktionsniveau hos en gruppe psykiatriske patienter ved indlaeggelse og udskrivning. Aspekter af pålideligheden af Sickness Impact Profile.

A comparison was undertaken between a method of personal assessment of the functional level and the health related quality of life, the Sickness Impact Profile (SIP) and a method based on observers, the Nurses' Observation Scale for Inpatient Evaluation, in a little group of mentally ill patients. This revealed good sensitivity as regards the registered effect of treatment and fairly good agreement between the results. SIP has gradually been demonstrated to be a well proved and widely employed method within many medical specialties with both internal and external validity.

[Study of the quality of measurement by the Sickness Impact Profile. Assessment of the reliability of a method to determine the functional level of psychiatric patients]. / Undersøgelse af målekvalitet af Sickness Impact Profile. Vurdering af pålideligheden af en metode til bestemmelse af funktionsniveau, specielt med hensyn til psykiatriske patienter.

The Sickness Impact Profile (SIP) is a questionnaire method of assessing the functional level within 12 fields which together provide a generalized measurement of the level of health in agreement with the definition of health by WHO. In the present investigation, the method was employed for the first time occasion for 58 suitable psychiatric patients and the result of Rasch's item-analysis of the replies to the individual questions showed altogether scales of good measurement quality. A single question, however, appeared to be unsuitable. The item-analysis is a demanding measurement for the internal validity and homogeneity and it supplements foreign investigations of the criteria-related validity of SIP.

[Evaluation of the level of function before and after treatment at a psychiatric day-hospital. Are you better, or are you well]. / Vurdering af funktionsniveau før og efter behandling i psykiatrisk daghospital. "Fik du det bedre, eller fik du det godt?"

A pilot project was carried out to assess the effect of group therapy. This demonstrates the employment of a method of measuring general health, the Sickness Impact Profile. Employment of this method before and after the period of therapy could demonstrate significant improvement in relevant functional fields and development towards normalization of health in the 12 categories which describe this.

Plasma ratio tryptophan/neutral amino acids in relation to clinical response to paroxetine and clomipramine in patients with major depression.

The pretreatment plasma ratio of tryptophan (Trp) to other large neutral amino acids (LNAA), thought to reflect brain serotonin formation, was determined in 44 inpatients with major depression, who were subsequently treated double-blind on a fixed-dose schedule for 4 weeks with the selective serotonin uptake inhibitor paroxetine (n = 27) or clomipramine (n = 17). The study took place at four clinical centers. Endogenous and non-endogenous depressives were comparable with respect to the ratio Trp/LNAA and clinical improvement and were therefore analyzed together. The clomipramine group showed a significant inverse correlation between ratio Trp/LNAA and improvement, and patients with a ratio Trp/LNAA below the mean showed a trend towards greater improvement than patients with a higher ratio but with comparable serum drug levels. The improvement in the paroxetine group was significantly inversely correlated with the Trp concentration but not with the ratio Trp/LNAA. The findings accord with previous trials of various antidepressant treatments, in which about 25% of the variance in therapeutic response associates with pretreatment plasma amino acid profiles.