Lower cognitive functioning has been documented across psychiatric disorders and hypothesized to be a core deficit of mental disorders. Situating psychopathology and cognition as part of a unitary construct is therefore important to understanding the etiology of psychiatric disorders. The current study aims to test competing structural models of psychopathology and cognition in a large national cohort of adolescents.

The analytic sample consisted of 1189 participants aged 16–17 years, screened by the Israeli Draft Board. Psychopathology was assessed using a modified version of the Brief Symptom Inventory, and cognition was assessed based on four standardized test scores ((1) mathematical reasoning, concentration, and concept manipulation; (2) visual-spatial problem-solving skills and nonverbal abstract reasoning; (3) verbal understanding; (4) categorization and verbal abstraction). Confirmatory factor analysis was implemented to compare competing structural models of psychopathology with and without cognition. Sensitivity analyses examined the models in different subpopulations.

Confirmatory factor analysis indicated a better model fit of psychopathological symptoms without cognition (RMSEA = 0.037; TLI = 0.991; CFI = 0.992) than with cognition (RMSEA = 0.04–0.042; TLI = 0.987–0.988; CFI = 0.988–0.989). Sensitivity analyses supported the robustness of these results with a single exception. Among participants with low cognitive abilities (N = 139), models that integrated psychopathological symptoms with cognition had a better fit compared to models of psychopathology without cognition.

The current study suggests that cognition and psychopathology are, generally, independent constructs. However, within low cognitive abilities, cognition was integral to the structure of psychopathology. Our results point toward an increased vulnerability to psychopathology in individuals with low cognitive abilities and may provide valuable information for clinicians.

The Brief Symptom Inventory (BSI-53) was originally developed as a shorter alternative to the Symptom Checklist-90R, which captures a breath of psychopathology. Subsequently, the BSI-53 was further streamlined to an 18-item scale assessing psychological distress in terms of somatization (S), anxiety (A), and depression (D) – also known as the “SAD Triad”. The BSI-18 has been shown to have good validity in the German general population.

The objective of the present study was to further improve the ease of use of the BSI as a clinical screening tool by developing a reliable and valid 9-item version of the BSI-18.

A representative sample of the German general population (N=2,516) was surveyed for demographic information and completed a variety of questionnaires, including the BSI-18. Confirmatory factor analyses, item-level statistics, and correlations were used to select three rather heterogeneous items for each subscale and confirm the model fit.

The proposed 3-factor model of the BSI-9, corresponding to the SAD triad, demonstrated a good model fit. The internal consistency (Cronbach’s alpha) was .87 for the total scale, .72 for the somatisation scale, .79 for the depression scale, and .68 for the anxiety scale. Each of the subscales were significantly related to the Patient Health Questionnaire-4 and Hopkins Symptoms Checklist-25 in the hypothesized direction.

The BSI-9 provides researchers and clinicians with a brief, effective, and valid tool to screen for anxiety, depression, and somatization, thus preventing potential overload for research participants and flagging patients who might need further clinical assessment.

Research into the relationship between the subjective perception of clinical change and the objective evidence of the same is very limited. Less is known about the relationship between clinical judgments by mental health experts and the patient's perception of symptom change, in particular across different diagnostic groups.

This study aims to determine the level of concordance between the HONOS as a tool for clinical outcome monitoring and the self-reported change in psychopathology in a total sample of psychiatric patients as well as stratified by their primary diagnosis at admission.

A consecutive sample of patients admitted to a Swiss psychiatric hospital for either alcohol use disorders, schizophrenic psychoses, mood disorders, anxiety and somatoform disorders, or personality disorders, was assessed using the Brief Symptom Inventory (BSI) at admission and at discharge. The HoNOS were rated by the responsible clinicians. Complete data of admission and discharge were available from approximately 600 cases. Reliable change index (RCI) will be calculated to determine a clinically meaningful change based on the HoNOS scores. Concordance of RCI and change in BSI scores will be explored and compared between different diagnostic groups.

According to our preliminary results from this ongoing evaluation program, we hope to provide a step towards a deeper understanding of the interrelationship between clinical judgments and the course of subjectively experienced mental health problems.

The authors have not supplied their declaration of competing interest.

In psychiatric practice, the assessment of change from pre- to post-treatment is a key approach for monitoring treatment effects and for the prediction of treatment outcomes. The Health of the Nation Outcome Scales (HoNOS) as a clinician-rated measure and the Brief Symptom Inventory (BSI) as a self-report measure are tools (that are) often incorporated in outcome monitoring. Their usefulness, however, has been questioned by two important issues: their psychometric properties and their lack of concordance.

The aim of the study is to evaluate the responsiveness of HoNOS and BSI as well as their interactions to predict clinical meaningful change according to the Global Clinical Impression (CGI) as quasi-gold standard for treatment outcome.

A consecutive sample of patients admitted to a Swiss psychiatric hospital for either alcohol use disorders, schizophrenic psychoses, mood disorders, anxiety and somatoform disorders, or personality disorders was assessed with Brief Symptom Inventory (BSI) at admission and discharge. The HoNOS and the CGI were rated by the responsible clinicians at admission and discharge. Ordinal logistic regressions will be conducted using the CGI categories as ordered categorical outcome. HoNOS and BSI scores as well as their interaction terms will be used as independent variables.

Complete data of admission and discharge is available from approximately 600 cases. Graphical presentations will illustrate the resulting associations.

The authors have not supplied their declaration of competing interest.