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

Background: Effective psychiatric care requires reliable measurement of patient progress and outcome. The current study aimed to assess the clinical validity of the WHO Wellbeing Index (WHO-5; Bech, P., Gudex, C., Johansen, K.S., 1996. The WHO (Ten) Wellbeing Index: validation in diabetes. Psychotherapy and Psychosomatics 65, 183-190.) for use as a measure of individual treatment response and outcome in mental health care. Method: Three hundred and eighteen consecutive inpatients and day patients at an Australian private psychiatric facility completed the WHO-5. SF-36 and DASS-21 routinely during treatment, and 152 undergraduate students completed the WHO-5. Results: The WHO-5 was shown to be a measure with high reliability, validity and sensitivity to change, for use with patients who have affective or neurotic primary diagnoses. Further to this, regression analyses demonstrated that early scores on the measure predicted final outcome. Criteria for clinically significant recovery are also presented. Limitations: The results may be generalized to samples with primary diagnoses of affective and anxiety disorders. Assessment of the WHO-5 as a measure of treatment response is warranted in other patient samples. Conclusions: The current findings illustrate the potential of the WHO-5 as a quick, reliable and valid means for assessing patient outcome and monitoring patient response to treatment in psychiatric services. (C) 2009 Elsevier B.V. All rights reserved.