title: Characterizing outcome preferences in patients with psychotic disorders: a discrete choice conjoint experiment.
abstract: The majority of individuals with schizophrenia will achieve a remission of psychotic symptoms, but few will meet criteria for recovery. Little is known about what outcomes are important to patients. We carried out a discrete choice experiment to characterize the outcome preferences of patients with psychotic disorders. Participants (N=300) were recruited from two clinics specializing in psychotic disorders. Twelve outcomes were each defined at three levels and incorporated into a computerized survey with 15 choice tasks. Utility values and importance scores were calculated for each outcome level. Latent class analysis was carried out to determine whether participants were distributed into segments with different preferences. Multinomial logistic regression was used to identify predictors of segment membership. Latent class analysis revealed three segments of respondents. The first segment (48%), which we labeled "Achievement-focused," preferred to have a full-time job, to live independently, to be in a long-term relationship, and to have no psychotic symptoms. The second segment (29%), labeled "Stability-focused," preferred to not have a job, to live independently, and to have some ongoing psychotic symptoms. The third segment (23%), labeled "Health-focused," preferred to not have a job, to live in supervised housing, and to have no psychotic symptoms. Segment membership was predicted by education, socioeconomic status, psychotic symptom severity, and work status. This study has revealed that patients with psychotic disorders are distributed between segments with different outcome preferences. New approaches to improve outcomes for patients with psychotic disorders should be informed by a greater understanding of patient preferences and priorities.
authors.affiliation: Department of Psychiatry and Behavioural Neuroscience, Michael G. DeGroote School of Medicine, McMaster University, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada; Schizophrenia and Community Integration Service, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada. Electronic address: bzipursk@stjoes.ca.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Zipursky
authors.affiliation: Department of Psychiatry and Behavioural Neuroscience, Michael G. DeGroote School of Medicine, McMaster University, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada; McMaster Children's Hospital, Ron Joyce Children's Health Centre, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2. Electronic address: cunnic@hhsc.ca.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Cunningham
authors.affiliation: Department of Psychiatry and Behavioural Neuroscience, Michael G. DeGroote School of Medicine, McMaster University, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada; McMaster Children's Hospital, Ron Joyce Children's Health Centre, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2. Electronic address: stewartba@hhsc.ca.
authors.forename: Bailey
authors.initials: B
authors.lastname: Stewart
authors.affiliation: Department of Psychiatry and Behavioural Neuroscience, Michael G. DeGroote School of Medicine, McMaster University, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada; McMaster Children's Hospital, Ron Joyce Children's Health Centre, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2. Electronic address: rimas@hhsc.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Rimas
authors.affiliation: Schizophrenia and Community Integration Service, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada. Electronic address: ecole@stjosham.on.ca.
authors.forename: Emily
authors.initials: E
authors.lastname: Cole
authors.affiliation: Department of Psychiatry and Behavioural Neuroscience, Michael G. DeGroote School of Medicine, McMaster University, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada; Schizophrenia and Community Integration Service, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, Ontario L8N3K7, Canada. Electronic address: smcdermi@stjosham.on.ca.
authors.forename: Stephanie McDermid
authors.initials: SM
authors.lastname: Vaz
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002755:Choice Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology*; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires
keywords: Conjoint analysis; Discrete choice experiment; First episode psychosis; Outcomes; Patient preferences; Schizophrenia