The HEALTH-49 is a self-rating instrument that allows for the comprehensive and economic assessment of generic aspects of psychosocial health. It is highly suitable for use in clinical practice. The questionnaire is available as a free download from http://www.hamburger-module.de/

The few studies that have investigated the relationship between trauma and dissociative symptoms in patients with schizophrenia have not assessed the role of the severity of psychotic symptoms. The current study examined correlations among five domains of childhood trauma and dissociative symptoms in 30 female patients with schizophrenia spectrum disorders, using the Dissociative Experiences Scale and the Childhood Trauma Questionnaire. Psychotic symptoms were measured by the Positive and Negative Syndrome Scale. Consistent with previous studies, high levels of childhood traumatic experiences were found (Childhood Trauma Questionnaire total score M = 48.5, SD = 18.3). Physical neglect and emotional abuse showed significant correlations with dissociative symptoms at admission. When patients were stabilized, about a month after admission, emotional abuse still showed a significant correlation with dissociative symptoms. However, in contrast to previous findings, Dissociative Experiences Scale findings were not stable over time. Our results confirm the relevance of childhood trauma in schizophrenic patients but also demonstrate the need to develop appropriate methodologies for measuring dissociation in this population.

No abstract

Background: The assessment of the severity of a mental illness is a central component in the treatment of patients with mental disorders in both the in- and outpatient settings. In Great Britain, the ‘Health of the Nation Outcome Scales, HoNOS’ were developed to assess the health and social functioning of patients with mental disorders. Aims: To examine the psychometric properties, especially the feasibility and reliability, of a German version of the HoNOS (HoNOS-D) and to thus provide international data for the comparison of different mental health services. Sampling and Methods: The HoNOS was translated into German (HoNOS-D) in an extensive and multilayered consensus procedure. The HoNOS-D was then reviewed within the framework of a pilot study on quality assurance measures implemented by the German statutory health insurance institutes in 11 hospitals. Assessments were made of the psychometric qualities of feasibility and reliability using a representative sample of patients with mental and behavioral disorders. Results: An analysis of the feasibility of the HoNOS-D showed a range of missing values between 1.3 and 4.5% for 11 of the 12 items. An item analysis showed that three items of the HoNOS-D are particularly positively skewed. In most instances, the individual items of the rating scale exhibited only slight correlations to each other. With regard to retest reliability, satisfactory intraclass correlations between 0.80 and 0.91 were seen for 9 of the 12 items. Conclusions: The authors of the original version of the HoNOS [Wing et al.:Br J Psychiatry 1998;172:11–18] primarily emphasized the feasibility of the instrument and the independence of the individual items and dimensions. The analysis of the missing values showed satisfactory results for feasibility. The intercorrelation matrix of the individual items also exhibited only few correlations >0.30. The retest reliability also proves to be satisfactory for the majority of the items. The narrow distribution of some of the items must be critically discussed in comparison to analyses of results in other countries (e.g. Great Britain) and other settings (e.g. inpatient psychiatric hospitals or outpatient psychotherapy).

The Health of the Nation Outcome Scales (HoNOS) is an internationally-established clinician-rating instrument for the differential assessment of the severity of patients with mental disorders. The aim of this study was to examine the validity of the German version of the HoNOS (HoNOS-D). Evaluation of validity, including factor validity, convergent and discriminant validity and sensitivity to change, was conducted on a large, virtually representative, clinical sample of patients with mental disorders in inpatient psychotherapy (Study 1, N = 3169). Additional assessment of criterion-based validity was completed using another clinical sample of patients with mental disorders (Study 2, N = 55). Although factor validity of the HoNOS-D and its total score could not be confirmed as expected, the majority of single items of the HoNOS-D proved to be valid in terms of convergent validity, criterion-based validity and sensitivity to change. Hence, single items, rather than the total score of the HoNOS-D, can be recommended for obtaining a picture of the impairment of patients with mental disorders in the clinical setting.