Health of the Nation Outcome Scales (HoNOS): use in an Irish psychiatric outpatient population

Abstract

Objectives: To evaluate the clinical utility and validity of the Health of the Nation Outcome Scales (HoNOS) in an Irish catchment area psychiatric service.Method: One hundred consecutive outpatients were assessed using the HoNO S and Global Assessment of Functioning (GAF) scales.Results: It was feasible to administer HoNOS in day-to-day clinical practice. There was a statistically significant correlation between the HoNO S and GAF scores. Attenders at the outpatient department had significantly lower HoNOS scores compared to individuals assessed on domiciliary visits or at the day hospital. Individuals with schizophrenia had significantly higher HoNO S scores compared to affective disordered patients. However, this difference was confined to the Social subscale of HoNOS.Conclusions: Although these findings indicate that HoNOS has significant convergent and criterion validity as a measure of psychiatric morbidity, its widespread use in day-to-day clinical practice may be premature.

The validity of the German version of the Health of the Nation Outcome Scales (HoNOS‐D): a clinician‐rating for the differential assessment of the severity of mental disorders

“…too dominant, too insecure). Contrary to empirical fi ndings of other studies (Browne et al, 2000;McClelland et al, 2000;Parker et al, 2002), this study was able to show that none of the 12 HoNOS-D items correlated with the clinician-rating of the GAF at suffi ciently large effect size. This could be due to the fact that the information required for the assessment of social functioning was only partly provided in the video-based recording of the standardized and structured interviews in Study 2.…”

Multidisciplinary activities in a community mental health service: relationship to Health of the Nation Outcome Scale scores and diagnosis

“…17 These findings support the current emphasis on socioadaptive functioning in people with severe and enduring mental illnesses as a target for mental health services. 18 Previous work has used the HoNOS to identify individuals suitable for variants of community psychiatry (e.g.…”

A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures

“…The ability of the HoNOS to discriminate between consumer groups differentiated on a range of treatment- and service-based indicators has also been used to test its concurrent validity. Several studies have found high total scores on the HoNOS to be associated with diagnoses of drug and alcohol, psychotic and bipolar disorders, high scores on items relating to hallucinations/delusions and social and cognitive problems to be associated with a diagnosis of schizophrenia, high scores on items relating to aggressive behaviour, drinking/drug taking and anxiety to be associated with a diagnosis of mania, and high scores on items relating to suicidal thoughts/behaviours, physical illness and depressed mood to be associated with a diagnosis of depression [ 16 , 20 , 24 , 26 , 37 , 38 ]. Similarly, a number of studies have found that the HoNOS can discriminate between consumers with differing levels of need or disability, as indicated by their current or expected location of treatment – e.g., those receiving standard case management versus those assertive case management [ 39 ], those in residential/nursing home, day patient, outpatient and inpatient settings [ 14 , 15 , 28 ], and those in long-stay settings with low, medium and high expectations of discharge [ 40 ].…”

“…There has been considerable debate about the feasibility/utility of the HoNOS. The least enthusiastic authors have argued that it is of limited value in informing care planning [ 24 , 51 - 55 ]. More positive authors have suggested it is a comprehensive, user-friendly tool that is likely to have utility in routine outcome measurement [ 1 , 16 , 19 , 28 , 38 , 39 , 56 ], and, with other evidence, could make a valuable contribution in informing clinical judgements [ 2 ].…”