Introduction: From both a clinical and research perspective, it is important to determine what constitutes a perceivable change in commonly used outcome measures. Objective: We aimed to do so for the Symptom Checklist-90-Revised (SCL-90-R). Methods: Patients from a large real-world sample treated with inpatient psychotherapy (n = 4,791) rated improvements in symptoms on a global 5-point Likert scale at discharge. These ratings were related to pre-post changes in the Global Severity Index (GSI) of the SCL-90-R by use of equipercentile linking. Results: A patient rating of 5 (“clearly improved”) was found to be equivalent to an absolute pre-post difference in the GSI of 0.67 or to a percentage improvement of 54%, with the latter corresponding to the common definition of response as a 50% reduction in symptoms. A rating of 1 (“clearly worse”) was equivalent to an increase in the GSI #x3e;0.50 and to a percentage worsening #x3e;55%. “Slightly improved” or “slightly worse” (ratings of 4 or 2) corresponded to pre-post changes in the GSI of 0.07 and 0.50. For severely disordered patients, larger changes were required for ratings of improvement, and for less severely disordered patients, larger changes were required for ratings of worsening. Results for depressive, anxiety, and personality disorders were widely consistent with those of the total sample. Conclusions: This study is the first to link patient ratings of improvement or worsening to changes in the SCL-90-R. Results are relevant to both the interpretation of changes in individual patients and of effect sizes in outcome research. Results require replication.
Psychother Psychosom

中文翻译：

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改善或不改善：患者对症状改善的看法 - 在大型真实世界治疗样本中将 SCL-90-R 与患者评定的全球改善联系起来。

简介：从临床和研究的角度来看，重要的是确定什么构成了常用结果测量中可感知的变化。目标：我们旨在为 Symptom Checklist-90-Revised (SCL-90-R) 这样做。方法：来自接受住院心理治疗的大型真实世界样本的患者 ( n = 4,791) 在出院时使用全球 5 点李克特量表对症状的改善进行评分。这些评级与 SCL-90-R 的全球严重性指数 (GSI) 的前后变化有关，使用等百分位链接。结果：发现患者评分为 5（“明显改善”）相当于 GSI 的绝对前后差异 0.67 或百分比改善 54%，后者对应于响应的常见定义为 50症状减轻 %。1 级（“明显更差”）相当于 GSI #x3e;0.50 的增加和 #x3e;55% 的恶化百分比。“略有改善”或“略差”（评级为 4 或 2）对应于 0.07 和 0.50 的 GSI 前后变化。对于严重障碍患者，改善评级需要更大的变化，而对于不太严重的患者，恶化评级需要更大的变化。抑郁、焦虑和人格障碍的结果与总样本的结果大体一致。结论：该研究首次将患者的改善或恶化评级与 SCL-90-R 的变化联系起来。结果与个体患者变化的解释和结果研究中的效应大小相关。结果需要复制。
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