Monitoring treatment response and outcomes using the World Health Organization's Wellbeing Index in psychiatric care

Early identification of treatment non-response utilizing the Patient Health Questionnaire (PHQ-9)

“…Herein, the overall results of the diagnostic efficiency statistics associated with a dynamic metric of early response utilizing a depression measure (the 2-week PHQ-9 change score) indicated that it is a strong predictor of non-response in patients presenting with severe depressive symptoms (PHQ-9 20). Consistent with previous literature that finds early treatment response predicts clinical outcome (Nierenberg et al, 2000, Quitkin et al, 2003, Szegedi et al, 2009, Uher et al, 2011, early change on the PHQ-9 may hold particular promise as a simple and cost-effective diagnostic test with more than adequate balance of sensitivity and specificity. The metric has comparable (and potentially better) diagnostic test characteristics than recently developed objective diagnostic tests for TRD as well as many other diagnostic tests for other medical conditions (see Table 4).…”

“…Despite decades of treatment innovation and research, rates of treatment non-response for individuals with disorders such as depression or schizophrenia approaches 50% of all patients Newnham et al, 2007Newnham et al, , 2010Rush and Trivedi, 1995;Rush et al, 2006;Stroup et al, 2006;Thase et al, 2007). While major depressive disorder (MDD) continues to be among the most prevalent psychiatric disorders worldwide (Bromet et al, 2011) symptoms of depression are so pervasive among individuals with psychiatric disorders in general that depression severity has been identified as a cross-cutting domain of psychopathology (L€ owe et al, 2008) and has been included as a DSM-5 cross-cutting measure of psychopathology (Narrow et al, 2013).…”

“…Based on similar patient-centered approaches that demonstrate improved outcomes for psychiatric patients (Howard et al, 1996;Whipple et al, 2003;Newnham et al, 2010;CritsCristoph et al, 2012;Shimokawa et al, 2010) patient-profiling allows Menninger practitioners to compare individual patient trajectories with the average treatment trajectory, prompting clinical consultation when flat or deteriorating courses are identified. The next step in the quality and outcomes progression was to build accurate, low-cost systems for early identification of non-response.…”

Fostering Cognitive-Emotional Processing in the Treatment of Depression: A Preliminary Investigation in Exposure-Based Cognitive Therapy

“…Before each session, patients completed the 5-item WHO Well-Being Index, which is also a highly sensitive and specific measure of clinical depression with high internal consistency, validity and sensitivity to change [17]. The German Cognitive-Behavioral Avoidance Scale assessed avoidant behaviors and has shown good factor structure, internal consistency, and test-retest reliabilities [18,19].…”

Well Being in Neurologic Illness

“…The finding in this paper of a very strong correlation between this index of WB and the other 5 other questions that cover different aspects of WB provides additional support to the validity of this measure in the group of patients studied. The potential value of the simple WHO WB survey is also supported by the fact that the scores from more complex instruments such as the SF-36 [10] and the QOLIE [11] which provide a more detailed picture of the patient's QOL correlate strongly with the scores on the WHO-5 questions [8,12].…”