Developing Brief Scales for Use in Clinical Practice: The Reliability and Validity of Single-Item Self-Report Measures of Depression Symptom Severity, Psychosocial Impairment Due to Depression, and Quality of Life
J Clin Psychiatry 2006;67(10):1536-1541
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Reliable, valid, user-friendly
measurement is necessary to successfully implement an
outcomes evaluation program in clinical practice.
Self-report questionnaires, which generally
correlate highly with clinician ratings, are a
cost-effective assessment option. However, even
self-administered questionnaires can be burdensome to patients
because many are lengthy. Consequently, we
developed and determined the reliability and validity of
ultra-brief, single-item assessments of 3 domains
important to consider when treating depressed
patients: symptom severity, psychosocial functioning,
and quality of life.
Method: In the first study (conducted June
1997 to March 2002), 1278 psychiatric outpatients
with various DSM-IV diagnoses completed
single-item assessments of psychosocial functioning and
quality of life as well as more detailed measures of
these constructs. In the second study (conducted
August 2003 to July 2004), 562 psychiatric outpatients
who were in ongoing treatment for a DSM-IV major
depressive episode completed a depression symptom scale and a measure of global severity of depression.
Results: The test-retest reliability of the
psychosocial functioning and quality-of-life items was
high. The single-item measures of symptom
severity, psychosocial functioning, and quality of life
were significantly correlated with the total scores and
individual item scores of longer measures of the
same constructs (p < .001). The single-item measures
significantly discriminated between depressed
patients in full remission, in partial remission, and in a
current depressive episode (p < .001).
Conclusion: These studies provide evidence
of the reliability and validity of single-item measures
of symptom severity, psychosocial functioning, and quality of life. Very brief measures, such as the
ones described in the present report, are not
burdensome for patients to complete and can be easily
incorporated into a busy clinical practice in order to
collect data on treatment effectiveness.