M. Ruggeri et al., Multivariate analysis of outcome of mental health care using graphical chain models - The South-Verona outcome project 1, PSYCHOL MED, 28(6), 1998, pp. 1421-1431
Background. Short-term outcome of mental health care was assessed in a mult
idimensional perspective using graphical chain models, a new multivariate m
ethod that analyses the relationship between variables conditionally, i.e.
taking into account the effect of antecedent and intervening variables.
Methods. GAF, BPRS, DAS (at baseline and after 6 months), LQL and VSSS (at
follow-up only) were administered to 194 patients attending the South-Veron
a community-based mental health service. Direct costs in the interval were
also calculated. Graphical chain models were used to analyse: (1) the assoc
iations between predictors (psychopathology, disability, functioning, asses
sed at baseline); (2) the effects of predictors on costs; and (3) the effec
t of predictors and costs on outcomes (psychopathology, disability, functio
ning, quality of life and service satisfaction) as well as their correlatio
n.
Results. Psychopathology, disability and functioning scores at baseline pre
dicted the corresponding scores at 6-month follow-up, with greater improvem
ent in the more severely ill. Higher psychopathology and poorer functioning
at baseline predicted higher costs and, in turn, costs predicted poorer fu
nctioning at follow-up. Outcome indicators polarized in two groups: psychop
athology, disability and functioning, which were highly correlated; and the
dyad service satisfaction and quality of life. Service satisfaction was hi
ghly related to quality of life and was predicted by low disability and hig
h dysfunctioning. No predictors for quality of life were found.
Conclusions. Graphical chain models were demonstrated to be a useful method
ology to analyse process and outcome data. The results of the present study
help in formulating specific hypotheses for future studies on outcome.