Structured assessment of mental health status in psychogeriatrics: validity of the French HoNOS65+.
OBJECTIVE
To assess the reliability, validity, and feasibility of a French version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+).


METHODS
Twenty mental health professionals completed the scale for 126 elderly patients. We assessed interrater reliability in inpatient and outpatient settings, together with construct and discriminant validity, as well as concurrent validity compared with several widely used clinical instruments.


RESULTS
Excellent agreement among raters was observed in the outpatient subgroup (kappa range 0.77 to 1.00), whereas interrater reliability was modest in the inpatient subgroup (kappa values < 0.55). In cases where the patient-caregiver relationship lasted more than 1 month, the reliability of the scale improved. Construct validity analysis revealed no subscale structure. All items except "self-injury" displayed high concurrent validity (significant Spearman correlations with 8 other questionnaires). In terms of discriminant validity, the "cognitive impairment" (area under the curve [AUC] 0.91) and "depressive symptoms" (AUC 0.79) items showed high sensitivity and specificity values.


CONCLUSIONS
Our results indicate that the French version of HoNOS65+ is a promising clinical assessment tool to evaluate mental disorders in the elderly in outpatient settings. We support its use in routine clinical practice, with the condition that a relatively long and individualized patient-caregiver relationship has been established.
Canuto
Alessandra
A
Division of Geriatric Psychiatry, University Hospitals of Geneva, Switzerland. Alessandra.Canuto@hcuge.ch
Weber
Kerstin
K
Gold
Gabriel
G
Notaridis
Grigorios
G
Michon
Agnès
A
Giardini
Umberto
U
Delaloye
Christophe
C
Herrmann
François
F
Giannakopoulos
Panteleimon
P
D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D007802:Language; D008297:Male; D008403:Mass Screening / Q000379:methods; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D015588:Observer Variation; D011369:Professional-Patient Relations; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires