title: Does a more specified version of the HoNOS (Health of the Nation Outcome Scales) increase psychometric properties of the inventory?
abstract: BACKGROUND
  The Health of the Nation Outcome Scales (HoNOS) is a clinician-rated instrument for the differentiated measurement of severity in patients with mental disorder. Item 8 of the instrument, assessing 'Other mental and behavioral problems', is particularly relevant for patients with affective disorders, anxiety disorders, and eating and personality disorders. However, some studies have shown that the scale possesses unsatisfactory psychometric properties. The objective of the present study was therefore to validate the psychometric properties of a more specified version of the HoNOS-D item 8.
  
  
  METHODS
  The instrument's reliability and validity were tested using a large, representative, clinical sample of patients with mental disorders (study 1: n = 1,918 and n = 1,357). Additional tests of reliability and criterion validity were performed using a further clinical sample of patients with mental disorders (study 2: N = 55).
  
  
  RESULTS
  The extended version of the HoNOS provides a differentiated picture of additional problem areas for the patient. Although inter-rater reliability indicates a need for more detailed instructions, the problem areas of item 8 proved on the whole to be suitable for measuring the extent and severity of mental problems that are present in addition to the primary problem.
  
  
  CONCLUSIONS
  In order to make the extended assessment of the HoNOS useful for clinical routine practice, a supplemental glossary is needed.
authors.affiliation: Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. sandreas@uke.uni-hamburg.de
authors.forename: Sylke
authors.initials: S
authors.lastname: Andreas
authors.forename: Sven
authors.initials: S
authors.lastname: Rabung
authors.forename: Robert
authors.initials: R
authors.lastname: Mestel
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
authors.forename: Maria
authors.initials: M
authors.lastname: Hausberg
authors.forename: Holger
authors.initials: H
authors.lastname: Schulz
mesh_terms: D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome