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Measuring Patient Symptom Change on Rural Psychiatry Units: Utility of the Symptom Checklist-90 Revised

J Clin Psychiatry 2000;61(7):493-497

Background: Mental health service providers have seen an increased need for demonstrating symptom reductions during the past decade. This change has been particularly evident to those working in inpatient psychiatry facilities where there is considerable need for a brief, easily administered, and low-cost means of tracking symptom change. The current study evaluated the utility of using the Symptom Checklist-90 Revised for tracking symptom reductions in patients admitted to rural adolescent and adult psychiatry units.

Method: Consecutive admissions to adolescent (N = 104) and adult (N = 125) psychiatry units located in a rural community hospital served as subjects. The mean length of stay was 8 days for adolescents and 7 days for adults. Patients were administered the Symptom Checklist-90 Revised at admission and just prior to discharge. Psychiatrists provided a DSM-IV primary diagnosis for each patient.

Results: Principal component analyses on both the adolescent and adult admission and discharge Symptom Checklist-90 Revised subscales resulted in a 1-factor solution. Repeated-measures ANOVAs demonstrated the Global Severity Index to be a sensitive measure of clinically significant admission-to-discharge symptom change. Analyses using psychiatrist-assigned diagnoses revealed that all diagnostic categories evinced significant admission-to-discharge symptom reductions.

Discussion: Implications for using the Symptom Checklist-90 Revised to evaluate clinically significant symptom changes on rural inpatient psychiatry units are discussed.