Journal of Clinical Medicine

Editorial

5 pages, 228 KiB

Open AccessEditorial

Reducing Health Inequalities in Individuals with Severe Mental Disorders: Harnessing Real-World Data and Patient-Reported Measures

by Laurent Boyer, Pascal Auquier, Dong Keon Yon, Pierre-Michel Llorca and Guillaume Fond

J. Clin. Med. 2023, 12(13), 4481; https://doi.org/10.3390/jcm12134481 - 04 Jul 2023

Cited by 1 | Viewed by 843

Abstract

Mental disorders are the leading cause of diminished lifespans worldwide and make up 5 of the top 10 most significant causes of disability [...] Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

Research

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16 pages, 474 KiB

Open AccessArticle

Assessment and Monitoring of the Quality of Clinical Pathways in Patients with Depressive Disorders: Results from a Multiregional Italian Investigation on Mental Health Care Quality (the QUADIM Project)

by Matteo Monzio Compagnoni, Giulia Caggiu, Liliana Allevi, Angelo Barbato, Flavia Carle, Barbara D’Avanzo, Teresa Di Fiandra, Lucia Ferrara, Andrea Gaddini, Cristina Giordani, Michele Sanza, Alessio Saponaro, Salvatore Scondotto, Valeria D. Tozzi, Giovanni Corrao and Antonio Lora

J. Clin. Med. 2023, 12(9), 3297; https://doi.org/10.3390/jcm12093297 - 05 May 2023

Cited by 5 | Viewed by 1618

Abstract

Ensuring adequate quality of care to patients with severe mental disorders remains a challenge. The implementation of clinical indicators aimed at assessing the quality of health care pathways delivered is crucial for the improvement of mental health services (MHS). This study aims to [...] Read more.

Ensuring adequate quality of care to patients with severe mental disorders remains a challenge. The implementation of clinical indicators aimed at assessing the quality of health care pathways delivered is crucial for the improvement of mental health services (MHS). This study aims to evaluate the quality of care delivered to patients who are taken-into-care with depressive disorders by MHS. Thirty-four clinical indicators concerning accessibility, appropriateness, continuity, and safety were estimated using health care utilization databases from four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). A total of 78,924 prevalent patients treated for depressive disorders in 2015 were identified, of whom 15,234 were newly engaged by MHS. During the year of follow-up, access to psychotherapeutic interventions was low, while the intensity was adequate; 5.1% of prevalent patients received at least one hospitalization in a psychiatric ward (GHPW), and 3.3% in the cohort of newly engaged in services. Five-out-of-10 patients had contact with community services within 14 days after GHPW discharge, but less than half of patients were persistent to antidepressant drug therapy. Furthermore, prevalent patients showed an excess of mortality compared to the general population (SMR = 1.35; IC 95%: 1.26–1.44). In conclusion, the quality of health care is not delivered in accordance with evidence-based mental health standards. Evaluation of health interventions are fundamental strategies for improving the quality and equity of health care. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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7 pages, 458 KiB

Open AccessCommunication

Changes in Revolving-Door Mental Health Hospitalizations during the COVID-19 Pandemic: A 5-Year Chart Review Study

by Giovanni Napoli, Marco Garzitto, Vincenzo Magliulo, Rossana Carnemolla, Calogero Anzallo, Matteo Balestrieri and Marco Colizzi

J. Clin. Med. 2023, 12(7), 2681; https://doi.org/10.3390/jcm12072681 - 04 Apr 2023

Cited by 4 | Viewed by 1670

Abstract

This study assessed changes in revolving-door (RD) mental health hospitalizations during the COVID-19 pandemic. A 5-year retrospective hospital chart review was performed, collecting revolving-door hospitalization, sociodemographic, and clinical data. Out of 1036 patients, 5.69% had RD hospitalizations, which accounted for 10.38% of all [...] Read more.

This study assessed changes in revolving-door (RD) mental health hospitalizations during the COVID-19 pandemic. A 5-year retrospective hospital chart review was performed, collecting revolving-door hospitalization, sociodemographic, and clinical data. Out of 1036 patients, 5.69% had RD hospitalizations, which accounted for 10.38% of all recorded hospitalizations. Further, a higher number of RD hospitalizations occurred following the pandemic outbreak, which is unlikely to have been a result of the confounding effect of trimester and month of hospitalization. Finally, several sociodemographic and clinical characteristics recurred more frequently in the context of RD hospitalizations, such as being younger, being compulsorily admitted, being an absconding patient, and being referred by a public service. Certain diagnostic categories occurred more frequently among RD hospitalizations, including psychotic, personality, and substance use disorders, as well as intellectual disability. Patients with specific characteristics are more likely to incur in RD hospitalizations, requiring the implementation of supportive treatment plans, especially following the pandemic outbreak. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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9 pages, 287 KiB

Open AccessArticle

Pre and Post Pandemic Depressive and Anxious Symptoms in Children and Adolescents in Northern Chile

by Alejandra Caqueo-Urízar, Diego Atencio-Quevedo, Felipe Ponce-Correa, Patricio Mena-Chamorro, Alfonso Urzúa and Jerome Flores

J. Clin. Med. 2023, 12(4), 1601; https://doi.org/10.3390/jcm12041601 - 17 Feb 2023

Cited by 3 | Viewed by 1885

Abstract

The psychological effects of the COVID-19 pandemic still represent a focus of concern, especially in children and adolescents who are a group particularly vulnerable to the psychological consequences of the COVID-19 pandemic, mainly due to the loss of socialization and leisure spaces. The [...] Read more.

The psychological effects of the COVID-19 pandemic still represent a focus of concern, especially in children and adolescents who are a group particularly vulnerable to the psychological consequences of the COVID-19 pandemic, mainly due to the loss of socialization and leisure spaces. The aim of the study is to determine the variation in the levels of depressive and anxious symptomatology in children and adolescents in the North of Chile. Methods: A Repeated cross-sectional design (RCS) was used. The sample consisted of a total of 475 students aged 12 to 18 years (high school) from educational establishments in the city of Arica. To evaluate the changes in the mental health of students associated with the COVID-19 pandemic, the same mental health measures applied to students were compared in two waves (2018–2021). Results: An increase in the symptomatology levels of depression, anxiety, social anxiety, and problems with the family, while a decrease in problems with school and peers was observed. Conclusions: The results show that there is an increase in mental health problems associated with the periods of time in which the COVID-19 pandemic transformed the social relation spaces and classrooms of secondary school students. The observed changes point to future challenges, which include that it may be important to improve the coordination and integration of mental health professionals in educational centers and schools. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

12 pages, 3270 KiB

Open AccessArticle

Do Sensory Impairments Portend Cognitive Decline in Older Chinese Adults? Longitudinal Evidence from a Nationally Representative Survey, 2011–2018

by Yifan Zhou, Jin Wei, Qinglei Sun, Haiyun Liu, Ye Liu, Jianfeng Luo and Minwen Zhou

J. Clin. Med. 2023, 12(2), 430; https://doi.org/10.3390/jcm12020430 - 05 Jan 2023

Cited by 4 | Viewed by 1818

Abstract

Previous studies on longitudinal sensory-cognition association are limited and have yielded inconsistent conclusions in western and developed countries. The present study obtained data from the China Health and Retirement Longitudinal Survey (CHARLS, 2011–2018) and aimed to investigate the longitudinal effects of sensory impairments [...] Read more.

Previous studies on longitudinal sensory-cognition association are limited and have yielded inconsistent conclusions in western and developed countries. The present study obtained data from the China Health and Retirement Longitudinal Survey (CHARLS, 2011–2018) and aimed to investigate the longitudinal effects of sensory impairments including single vision impairment (SVI), single hearing impairment (SHI), and dual sensory impairment (DSI) on cognitive decline in middle-aged and older Chinese population. In total, 11,122 participants accomplished all 4 interviews over 8 years and were included. Cognitive performances were assessed using Mini-Mental Status Examination (MMSE) and self-reported sensory status were accepted as well. Confounding variables included age, sex, educational level, marital status, medical, and lifestyle related information. The impact of sensory impairment on cognitive decline over time was assessed using linear mixed-effects models (LMM). After being adjusted for multiple confounders, SVI/SHI/DSI were all shown to be significantly associated with executive functions, episodic memory impairment, and global cognitive decline over 8 years (all p < 0.05). Such associations become less significant among female and relatively younger populations (45–59 years old). Single vision and hearing impairments, along with dual sensory impairment, are all independently associated with subsequent cognitive decline among middle-aged and older Chinese populations over 8 years of longitudinal observation. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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18 pages, 608 KiB

Open AccessArticle

Breast Cancer Care Pathways for Women with Preexisting Severe Mental Disorders: Evidence of Disparities in France?

by Anna-Veera Seppänen, Fabien Daniel, Sophie Houzard, Christine Le Bihan, Magali Coldefy and Coralie Gandré

J. Clin. Med. 2023, 12(2), 412; https://doi.org/10.3390/jcm12020412 - 04 Jan 2023

Cited by 2 | Viewed by 1944

Abstract

The excess cancer mortality in persons with severe mental illness (SMI) has been well documented, and research suggests that it may be influenced by care-related factors. Our objective was to assess breast cancer care pathways in women with SMI in France, using an [...] Read more.

The excess cancer mortality in persons with severe mental illness (SMI) has been well documented, and research suggests that it may be influenced by care-related factors. Our objective was to assess breast cancer care pathways in women with SMI in France, using an exhaustive population-based data-linkage study with a matched case-control design. The cases were 1346 women with incident breast cancer in 2013/2014 and preexisting SMI who were matched with three controls without SMI presenting similar demographics, initial breast cancer type, and year of incidence. We compared cancer care pathways and their quality for cases and controls, using a consensual set of indicators covering diagnosis, treatment, follow-up, and mortality (until 2017). After adjusting for covariates, cases had lower odds to undergo the main diagnostic tests, lumpectomy, adjuvant chemotherapy, and radiotherapy, as well as hormone therapy, but higher odds for mastectomy. Suboptimal quality in cancer pathways was observed for both groups, but to a higher extent for cases, especially for not receiving timely care after diagnosis and post-treatment follow-up. Breast cancer mortality, considering competing risks of deaths, was significantly elevated in women with SMI. These findings highlight disparities in cancer care pathways for individuals with SMI, as well as specific aspects of the care continuum which could benefit from targeted actions to reach equity of outcomes. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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9 pages, 770 KiB

Open AccessArticle

Potential Usefulness of Blood Urea Nitrogen to Creatinine Ratio in the Prediction and Early Detection of Delirium Motor Subtype in the Intensive Care Unit

by Woo Rhim Park, Hye Rim Kim, Jin Young Park, Hesun Erin Kim, Jaehwa Cho and Jooyoung Oh

J. Clin. Med. 2022, 11(17), 5073; https://doi.org/10.3390/jcm11175073 - 29 Aug 2022

Cited by 2 | Viewed by 1933

Abstract

Prediction and early detection of delirium can improve patient outcomes. A high blood urea nitrogen to creatinine ratio (BCR), which reflects dehydration, has been reported as a risk factor for delirium. Additionally, BCR represents skeletal muscle loss in intensive care unit (ICU) patients, [...] Read more.

Prediction and early detection of delirium can improve patient outcomes. A high blood urea nitrogen to creatinine ratio (BCR), which reflects dehydration, has been reported as a risk factor for delirium. Additionally, BCR represents skeletal muscle loss in intensive care unit (ICU) patients, which can have critical implications for clinical outcomes. We investigated whether BCR could be used to predict the occurrence and motor subtype of delirium in ICU patients through a retrospective cohort study that included 7167 patients (50 years or older) admitted to the ICU. Patients were assessed daily using the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for ICU and categorized according to the delirium subtype. Participants were split into 10 groups according to BCR at ICU admission and the prevalence of each delirium subtype was compared. Multivariable logistic regression was then used for analysis. A higher BCR at ICU admission was associated with the development of hypoactive delirium. Moreover, BCR > 24.9 was associated with higher rates of hypoactive delirium. Our findings showed that a high BCR at ICU admission was associated with the development of hypoactive delirium, which suggested that BCR could be a potential biomarker for hypoactive delirium in ICU patients. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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11 pages, 1395 KiB

Open AccessArticle

Hospitalizations for Anorexia Nervosa during the COVID-19 Pandemic in France: A Nationwide Population-Based Study

by Jean-Christophe Chauvet-Gelinier, Adrien Roussot, Bruno Vergès, Jean-Michel Petit, Fabrice Jollant and Catherine Quantin

J. Clin. Med. 2022, 11(16), 4787; https://doi.org/10.3390/jcm11164787 - 16 Aug 2022

Cited by 7 | Viewed by 1537

Abstract

The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase [...] Read more.

The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase in hospitalizations for AN in France. We compared the number of hospitalizations with a diagnosis of AN during the 21-month period following the onset of the pandemic with the 21-month period before the pandemic using Poisson regression models. We identified a significant increase in hospitalizations for girls aged 10 to 19 years (+45.9%, RR = 1.46[1.43–1.49]; p < 0.0001), and for young women aged 20 to 29 (+7.0%; RR = 1.07[1.04–1.11]; p < 0.0001). Regarding markers of severity, there was an increase in hospitalizations for AN associated with a self-harm diagnosis between the two periods. Multivariate analysis revealed that the risk of being admitted for self-harm with AN increased significantly during the pandemic period among patients aged 20–29 years (aOR = 1.39[1.06–1.81]; p < 0.05 vs. aOR = 1.15[0.87–1.53]; NS), whereas it remained high in patients aged 10 to 19 years (aOR = 2.40[1.89–3.05]; p < 0.0001 vs. aOR = 3.12[2.48–3.98]; p < 0.0001). Furthermore, our results suggest that the pandemic may have had a particular effect on the mental health of young women with AN, with both a sharp increase in hospitalizations and a high risk of self-harming behaviors. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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16 pages, 366 KiB

Open AccessArticle

Real-World Functioning in Psychiatric Outpatients: Predictive Factors

by Paola Bozzatello, Benedetta Giordano, Cristiana Montemagni, Paola Rocca and Silvio Bellino

J. Clin. Med. 2022, 11(15), 4400; https://doi.org/10.3390/jcm11154400 - 28 Jul 2022

Cited by 5 | Viewed by 1844

Abstract

Introduction: Investigations on predictors of real-world functioning were mainly performed in patients with schizophrenia, while fewer studies have been conducted in other psychiatric disorders. Objective: Our objective was to identify clinical, socio-demographic, and illness-related predictors of real-world functioning during 12 months of standard [...] Read more.

Introduction: Investigations on predictors of real-world functioning were mainly performed in patients with schizophrenia, while fewer studies have been conducted in other psychiatric disorders. Objective: Our objective was to identify clinical, socio-demographic, and illness-related predictors of real-world functioning during 12 months of standard treatments in outpatients with different diagnoses. Methods: Outpatients (n = 1019) with schizophrenia (SZ), major depressive disorder (MDD), bipolar disorder (BD), and borderline personality disorder (BPD) were evaluated with the following tools: SCID-5-CV and SCID-5-PD, CGI-S, SAT-P, DAI-10, and PSP. Change of PSP (ΔPSP) between baseline and 12 months was used as the dependent variable in multiple regression analysis. Results: Higher PSP score at baseline and the achievement of main milestones predicted better functioning after follow-up in all subgroups of patients, with the exception of BD. In the total sample, ΔPSP was related to age of onset, treatments, and quality of life, and inversely related to psychiatric anamnesis, antidepressants, and global symptoms. In SZ, ΔPSP was related to adherence and quality of life. In MDD, ΔPSP was related to psychotherapy and quality of life, and inversely related to antidepressants and global symptoms. In BD, ΔPSP was related to age of onset, antipsychotics, and quality of life, while it was inversely related to psychiatric anamnesis. In BPD, antipsychotics, mood stabilizers, psychotherapy, and quality of life were directly related to ΔPSP, while suicidal attempts and global symptoms had an inverse relation. Conclusions: Several socio-demographic and illness-related variables predicted improvement of real-world functioning, besides psychopathology and severity of the disease. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

18 pages, 699 KiB

Open AccessArticle

Calibration and Validation of a PREMIUM-DT Item Bank to Measure the Experience of Drug Therapy for Patients with Severe Mental Illness

by Sara Fernandes, Laurent Boyer, Xavier Zendjidjian, Anderson Loundou, Jeremie Riedberger, Pierre-Michel Llorca, Pascal Auquier, Guillaume Fond and Collaborators of the French PREMIUM Group

J. Clin. Med. 2022, 11(15), 4278; https://doi.org/10.3390/jcm11154278 - 22 Jul 2022

Cited by 2 | Viewed by 1321

Abstract

The aim of this study was to (1) calibrate an item bank to measure patients’ experience of drug therapy for adult patients with SMIs and (2) develop computerized adaptive testing (CAT) to improve its use in routine practice. This is a cross-sectional, multicentric [...] Read more.

The aim of this study was to (1) calibrate an item bank to measure patients’ experience of drug therapy for adult patients with SMIs and (2) develop computerized adaptive testing (CAT) to improve its use in routine practice. This is a cross-sectional, multicentric study involving 541 patients with schizophrenia, bipolar disorder, and major depressive disorder. Analyses based on classical test and item response theories were performed. After 7 highly inter-correlated items and 4 items with low factor loadings were removed, the remaining 26 items were sufficiently unidimensional (RMSEA = 0.069, CFI = 0.969, TLI = 0.963) and showed adequate fit to the generalized partial credit model. There was no differential item functioning by gender, age, care setting, or diagnosis from moderate- to large-magnitude. The mean score was 46.0 ± 16.9 and was significantly higher for patients reporting good medication adherence. The resulting PREMIUM-DT item bank has strong psychometric properties, and CAT facilitates widespread use in clinical settings (an average of 8 items administered, corresponding to a reliability of >0.90). Our results suggest that practical information and information about the side effects of psychotropic treatments and how to cope with them should be targeted as a priority to improve patients’ experience of drug therapy. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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12 pages, 890 KiB

Open AccessArticle

Latent Profiles of Premorbid Adjustment in Schizophrenia and Their Correlation with Measures of Recovery

by Alejandra Caqueo-Urízar, Felipe Ponce-Correa, Carla Semir-González and Alfonso Urzúa

J. Clin. Med. 2022, 11(13), 3840; https://doi.org/10.3390/jcm11133840 - 02 Jul 2022

Cited by 3 | Viewed by 1764

Abstract

Premorbid adjustment (PA) has classically been defined as psychosocial functioning in the areas of education, occupation, social and interpersonal relationships prior to evidence of characteristic positive symptomatology. It is a concept which possesses ample evidence regarding its predictive nature for the course of [...] Read more.

Premorbid adjustment (PA) has classically been defined as psychosocial functioning in the areas of education, occupation, social and interpersonal relationships prior to evidence of characteristic positive symptomatology. It is a concept which possesses ample evidence regarding its predictive nature for the course of Schizophrenia. The study aimed to analyze the latent profiles of premorbid adjustment and their relationship with symptomatology, functionality, subjective recovery, stigma resistance and years of untreated psychosis. Latent class analysis (LCA) was used to elaborate a solution of three premorbid adjustment profiles in a sample of 217 patients diagnosed with Schizophrenia from Public Mental Health Centers in the city of Arica, Chile. The results show that premorbid adjustment was significantly correlated with recovery indicators and that latent profiles of better premorbid adjustment predict better outcomes in subjective recovery and stigma resistance. The results show that premorbid adjustment not only has implications for the severity of the disorder, but that psychosocial functioning prior to psychosis affects the patient’s subjectivity, the representation of the disorder and the recovery process. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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17 pages, 561 KiB

Open AccessArticle

Development and Calibration of the PREMIUM Item Bank for Measuring Respect and Dignity for Patients with Severe Mental Illness

by Sara Fernandes, Guillaume Fond, Xavier Zendjidjian, Pierre Michel, Karine Baumstarck, Christophe Lançon, Ludovic Samalin, Pierre-Michel Llorca, Magali Coldefy, Pascal Auquier, Laurent Boyer and Collaborators of the French PREMIUM Group

J. Clin. Med. 2022, 11(6), 1644; https://doi.org/10.3390/jcm11061644 - 16 Mar 2022

Cited by 3 | Viewed by 1871

Abstract

Most patient-reported experience measures (PREMs) are paper-based, leading to a high burden for patients and care providers. The aim of this study was to (1) calibrate an item bank to measure patients’ experience of respect and dignity for adult patients with serious mental [...] Read more.

Most patient-reported experience measures (PREMs) are paper-based, leading to a high burden for patients and care providers. The aim of this study was to (1) calibrate an item bank to measure patients’ experience of respect and dignity for adult patients with serious mental illnesses and (2) develop computerized adaptive testing (CAT) to improve the use of this PREM in routine practice. Patients with schizophrenia, bipolar disorder, and major depressive disorder were enrolled in this multicenter and cross-sectional study. Psychometric analyses were based on classical test and item response theories and included evaluations of unidimensionality, local independence, and monotonicity; calibration and evaluation of model fit; analyses of differential item functioning (DIF); testing of external validity; and finally, CAT development. A total of 458 patients participated in the study. Of the 24 items, 2 highly inter-correlated items were deleted. Factor analysis showed that the remaining items met the unidimensional assumption (RMSEA = 0.054, CFI = 0.988, TLI = 0.986). DIF analyses revealed no biases by sex, age, care setting, or diagnosis. External validity testing has generally supported our assumptions. CAT showed satisfactory accuracy and precision. This work provides a more accurate and flexible measure of patients’ experience of respect and dignity than that obtained from standard questionnaires. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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11 pages, 270 KiB

Open AccessArticle

The Validity of the SQoL-18 in Patients with Bipolar and Depressive Disorders: A Psychometric Study from the PREMIUM Project

by Laurent Boyer, Sara Fernandes, Melanie Faugere, Raphaelle Richieri, Pascal Auquier, Guillaume Fond and Christophe Lancon

J. Clin. Med. 2022, 11(3), 743; https://doi.org/10.3390/jcm11030743 - 29 Jan 2022

Cited by 2 | Viewed by 1437

Abstract

The S-QoL 18 is a self-administered questionnaire that assesses quality of life (QoL) among individuals with schizophrenia. This study aims to validate the S-QoL 18 in bipolar and depressive disorders for a more widespread use in psychiatric settings. This study was conducted in [...] Read more.

The S-QoL 18 is a self-administered questionnaire that assesses quality of life (QoL) among individuals with schizophrenia. This study aims to validate the S-QoL 18 in bipolar and depressive disorders for a more widespread use in psychiatric settings. This study was conducted in a non-selected sample of individuals with bipolar and depressive disorders in the day hospital of a regional psychiatric academic hospital. Two-hundred and seventy-two stable outpatients with bipolar (n = 73) and recurrent and persistent depressive (n = 199) disorders were recruited over a 12 month-period. The S-QoL 18 was tested for construct validity, reliability, and external validity. The eight-factor structure of the S-QoL 18 was confirmed by confirmatory factor analysis (RMSEA = 0.075 (0.064–0.086), CFI = 0.972, TLI = 0.961). Internal consistency and reliability were satisfactory. External validity was confirmed via correlations between S-QoL 18 dimension scores, symptomatology, and functioning. The percentage of missing data for the eight dimensions did not exceed 5%. INFIT statistics were ranged from 0.7 to 1.2, ensuring that all items of the scale measured the same QoL concept. In conclusion, the S-QoL 18 appears to be a valid and reliable instrument for measuring QoL in patients with bipolar and depressive disorders. The S-QoL 18 may be used by healthcare professionals in clinical settings to accurately assess QoL in individuals with bipolar and depressive disorders, as well as in schizophrenia. Full article

(This article belongs to the Special Issue Use of Real-World Data (RWD) to Improve Health Care and Outcomes in Patients with Mental Health Disorders)

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