Anticipated Benefits of Care (ABC): psychometrics and predictive value in psychiatric disorders.
BACKGROUND
Attitudes and expectations about treatment have been associated with symptomatic outcomes, adherence and utilization in patients with psychiatric disorders. No measure of patients' anticipated benefits of treatment on domains of everyday functioning has previously been available.


METHODS
The Anticipated Benefits of Care (ABC) is a new, 10-item questionnaire used to measure patient expectations about the impact of treatment on domains of everyday functioning. The ABC was collected at baseline in adult out-patients with major depressive disorder (MDD) (n=528), bipolar disorder (n=395) and schizophrenia (n=447) in the Texas Medication Algorithm Project (TMAP). Psychometric properties of the ABC were assessed, and the association of ABC scores with treatment response at 3 months was evaluated.


RESULTS
Evaluation of the ABC's internal consistency yielded Cronbach's alpha of 0.90-0.92 for patients across disorders. Factor analysis showed that the ABC was unidimensional for all patients and for patients with each disorder. For patients with MDD, lower anticipated benefits of treatment was associated with less symptom improvement and lower odds of treatment response [odds ratio (OR) 0.72, 95% confidence interval (CI) 0.57-0.87, p=0.0011]. There was no association between ABC and symptom improvement or treatment response for patients with bipolar disorder or schizophrenia, possibly because these patients had modest benefits with treatment.


CONCLUSIONS
The ABC is the first self-report that measures patient expectations about the benefits of treatment on everyday functioning, filling an important gap in available assessments of attitudes and expectations about treatment. The ABC is simple, easy to use, and has acceptable psychometric properties for use in research or clinical settings.
Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9119, USA. Diane.Warden@UTSouthwestern.edu
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Warden
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Trivedi
T J
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Carmody
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Gollan
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Kashner
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Lind
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Crismon
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Rush
D000223:Adaptation, Psychological; D000328:Adult; D000465:Algorithms; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D011619:Psychotropic Drugs