Standard set of patient-reported outcomes for personality disorder

Abstract

Purpose The purpose of the article is to present standard set of outcomes for people with personality disorder (PD), in order to facilitate patient outcome measurement worldwide. Methods The International Consortium for Health Outcomes Measurement (ICHOM) gathered a multidisciplinary international working group, consisting of 16 experts, including clinicians, nurses, psychologists, methodologists and patient representatives, to develop a standard set of outcome measures for people with PD. The Delphi method was used to reach consensus on the scope of the set, outcome domains, outcome measures, case-mix variables and time points for measuring outcomes in service users. For each phase, a project team prepared materials based on systematic literature reviews and consultations with experts. Results The working group decided to include PD, as defined by International Classification of Diseases 11th revision (ICD-11). Eleven core outcomes and three optional outcomes across four health domains (mental health, behaviour, functioning and recovery) were defined as those relevant for people with PD. Validated measures for the selected outcomes were selected, some covering more than one outcome. Case-mix variables were aligned to other ICHOM mental health standard sets and consisted of demographic factors and those related to the treatment that people received. The group recommended that most outcomes are measured at baseline and annually. Conclusion The international minimum standard set of outcomes has the potential to improve clinical decision making through systematic measurement and comparability. This will be key in improving the standard of health care for people with PD across the world.

Psychotherapies for borderline personality disorder: a focused systematic review and meta-analysis

“…Fortunately, efforts have been made recently by an international consortium of researchers to identify a core standard battery of outcomes for individuals with personality disorders. 99 To date, BPD-specific measures are available that allow for a very detailed assessment of individual BPD symptoms, like the Zan-BPD, 79 Clinical Global Impression Scale adapted for BPD (CGI-BPD) 100 or BPDSI-IV. 73 Until recently, several BPD-intrinsic outcomes that are specifically important for individuals affected are still neglected across all studies, like avoidance of abandonment, chronic feelings of emptiness or identity disturbance.…”

“…In terms of outcomes, a common core battery of relevant outcomes in BPD treatment studies would be most desirable, and future studies should address these recommendations. 99 From our point of view, outcome assessment should at least include an assessment of any BPD criteria as defined by DSM, which can be done by the use of the Zan-BPD, 79 BPSDI-IV 73 or CGI-BPD, for example. 100 To reflect the reality of individuals affected by BPD, the observation periods should be extended so long-term effects could be followed up.…”

Multinational evaluation of the measurement invariance of the Level of Personality Functioning Scale–brief form 2.0: Comparison of student and community samples across seven countries.

“…However, it may be necessary to combine the LPFS-BF 2.0 with other measures to capture certain aspects of ICD-11’s personality dysfunction construct in its entirety (e.g., aspects of harm to self/others, behavioral control, reality testing, and global psychosocial impairment). Encouragingly, the LPFS-BF 2.0 (in combination with WHO Disability Assessment Schedule for psychosocial impairment) was recently selected by an international research group as part of a “standard set” of self-report outcome measures designed to match the ICD-11 personality dysfunction classification (Prevolnik Rupel et al, 2021). Against the background of the introduction of ICD-11 , the AMPD of the DSM-5 , and the psychometric validation of a general severity factor across models and measures of personality dysfunction, the current findings offer preliminary support for international adoption of the LPFS-BF 2.0 as a standard instrument for routine, economical screenings, and diagnostics in various practice contexts.…”

“…Combined with its increasingly global use, open-access, brevity and ease of use, inclusion of only negatively worded items, 1 parallel with popular diagnostic systems, and numerous current and forthcoming translations, the LPFS-BF 2.0 stands out as a suitable candidate for becoming a worldwide measure of personality functioning. Encouragingly, the International Consortium for Health Outcomes Measurement has included the LPFS-BF 2.0 in the proposed standardized minimum set of outcomes (Prevolnik Rupel et al, 2021), thereby endorsing its potential for clinical use and outcome research across cultural and geographical settings.…”

Improving the methodological quality of randomized clinical trials assessing psychotherapy for borderline personality disorder: Recommendations for the future

“…This calls for a discussion of which outcomes are the most patient-important. A standard set of patient-reported outcomes for the International Classification of Diseases—11th version (ICD-11) personality disorder classification has recently been proposed by the International Consortium for Health Outcomes Measurement (ICHOM) multidisciplinary working group ( 32 ). However, these recommendations did not cover more objective outcomes.…”