The EPSILON study of schizophrenia in five European countries. Design and methodology for standardising outcome measures and comparing patterns of care and service costs.
BACKGROUND
There is a lack of cross-national research on care for people with schizophrenia.


OBJECTIVE
To produce standardised European versions of five instruments in key areas of mental health service research in five languages, and to compare data from five European countries regarding patients with schizophrenia and mental health care provision and costs.


METHODS
Five centres, in Amsterdam, Copenhagen, London, Santander and Verona, participated. Instruments assessing needs, service use, informal career involvement, quality of life, and service satisfaction were subjected to a conversion procedure including translation, back-translation, focus group discussion and reliability assessment. Patients of local mental health services with a Schedules for Clinical Assessment in Neuropsychiatry diagnosis of schizophrenia were interviewed.


RESULTS
Service provision varied between sites; 404 patients were studied. Instrument reliability was found to be good.


CONCLUSIONS
The instruments developed were reliable across the range of countries, and will facilitate future comparative health service research.
Becker
T
T
Department of Psychiatry, University of Leipzig.
Knapp
M
M
Knudsen
H C
HC
Schene
A
A
Tansella
M
M
Thornicroft
G
G
Vázquez-Barquero
J L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers; D003430:Cross-Sectional Studies; D003718:Denmark; D005069:Evaluation Studies as Topic; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D007558:Italy; D008131:London; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration / Q000600:supply & distribution*; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D017060:Patient Satisfaction; D011788:Quality of Life; D012044:Regression Analysis; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy; D012565:Schizophrenic Psychology; D013030:Spain