Measuring Patient Symptom Change on Rural Psychiatry Units: Utility of the Symptom Checklist-90 Revised

Background: Mental health service providers haveseen an increased need for demonstrating symptom reductionsduring the past decade. This change has been particularly evidentto those working in inpatient psychiatry facilities where thereis considerable need for a brief, easily administered, andlow-cost means of tracking symptom change. The current studyevaluated the utility of using the Symptom Checklist-90 Revisedfor tracking symptom reductions in patients admitted to ruraladolescent and adult psychiatry units.

Method: Consecutive admissions to adolescent (N= 104) and adult (N = 125) psychiatry units located in a ruralcommunity hospital served as subjects. The mean length of staywas 8 days for adolescents and 7 days for adults. Patients wereadministered the Symptom Checklist-90 Revised at admission andjust prior to discharge. Psychiatrists provided a DSM-IV primarydiagnosis for each patient.

Results: Principal component analyses on boththe adolescent and adult admission and discharge SymptomChecklist-90 Revised subscales resulted in a 1-factor solution.Repeated-measures ANOVAs demonstrated the Global Severity Indexto be a sensitive measure of clinically significantadmission-to-discharge symptom change. Analyses usingpsychiatrist-assigned diagnoses revealed that all diagnosticcategories evinced significant admission-to-discharge symptomreductions.

Discussion: Implications for using the SymptomChecklist-90 Revised to evaluate clinically significant symptomchanges on rural inpatient psychiatry units are discussed.