Effectiveness of Psychosocial Rehabilitation: Innovative Method of Results Assessment

Background: The main problem of evaluating the effectiveness of psychosocial rehabilitation (PSR) is incorrect methods of processing psychometric data obtained with the help of appropriate tools (scales and questionnaires), which are standard used to measure the effectiveness of interventions within the framework of the implementation of PSR procedures. The purpose of the study: 1) а systematic analysis of the problems of assessing the severity of mental disorders and the effectiveness of subsequent PSR; 2) development of cardinal algorithms for processing the initial expert information in order to obtain appropriate numerical criteria for the effectiveness of the PSR. Material and methods: a systematic analysis of domestic and foreign publications, based on the results of their own research on the problems of assessing patients’ conditions, as well as evaluating the effectiveness of a comprehensive long-term PSR program for people with schizophrenia and schizophrenic spectrum disorders in various forms of care (public organization, day hospital, hospital). As methods of information processing, clinical-psychopathological, psychometric, as well as methods of system analysis and the analytic hierarchy process (AHP) were used. Results: an innovative methodology and algorithms for processing expert clinical, psychopathological and psychometric information based on the AHP apparatus have been developed to develop criteria for the effectiveness of PSR. The cardinal difference between the proposed approach and the rank methods of processing initial information is that the results of processing initial expert information are obtained in the fundamental scale of AHP (numerical scale), which ensures the correct integration of psychometric and psychosocial characteristics of patients when considering diagnostic procedures, psychosocial therapy and rehabilitation. Conclusions: the calculations are based on expert assessments of the weight of areas of impaired functioning of patients and the corresponding changes in psychosocial characteristics. This ensures the universality of the methodology and algorithms for evaluating the effectiveness of any rehabilitation interventions: from psychosocial to physiotherapy.

1. Psihosocial’naya i kognitivnaya terapiya i reabilitaciya psihicheski bol’nyh. Prakticheskoe rukovodstvo / Pod red. IYа Gurovicha i AB Shmuklera. M.: Medpraktika-M. 2015. (In Russ.).

2. Yastrebov VS, Mitikhin VG, Solokhina TA, Mikhailova II. The system-oriented model of psychosocial rehabilitation. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2008;108(6):4–10. (In Russ.).

3. Pfanzagl J. Theory of measurement. In cooperation with V. Baumann and H. Huber. Wurzburg; Wien: Physica-Verlag. 1968.

4. Kupcov MI, Filipova EE, Slobodskaya IN, Pavlova SA, Koryachko AV, Zharkikh AA. Matematicheskie metody v psihologii. M.: Goryachaya liniya; Telekom. 2017. (In Russ.).

5. Novikov NYu. Teoriya shkal. Printsipy postroeniya etalonnykh protsedur izmereniya, kodirovaniya i upravleniya. M.: Fizmatlit. 2009. (In Russ.)

6. Mitikhin VG, Solokhina TA. Processing of rank data obtained using psychometric scales based on analytic hierarchy process. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2019;119(2):49–54. (In Russ.). doi: 10.17116/jnevro201911902149

7. Kabanov MM. Reabilitaciya psihicheski bol’nyh. L.: Medicina. 1978. (In Russ.).

8. Saaty TL. Decision making with dependence and feedback: The Analytic Network Process. Per. s angl. M.: Izd. LKI. 2008. (In Russ.).

9. Cuthbert B. The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry. 2014;13(1):28–35. doi: 10.1002/wps.20087

10. Markon KE. On hierarchically-informed measures of psychopathology. World Psychiatry. 2021;20(1):66–67. doi: 10.1002/wps.20812

11. Yastrebova VV, Solokhina TA. Clinical, social and psychological aspects of rehabilitation work in public organization: evaluation of effectiveness. Psychiatry (Moscow) (Psikhiatriya). 2018;79(3):52–61. (In Russ.). 10.30629/2618-6667-2018-79-51-60

12. Solokhina TA, Mitikhin VG, Yastrebova VV, Tyumenkova GV. Problems in assessment of the effectiveness of psychosocial rehabilitation and treatment: area of psychosocial interventions, tools and evaluation criteria. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2019;119(12):154–161. (In Russ.). doi: 10.17116/jnevro2019119121154

13. Mitikhin VG, Solokhina TA. Assessment of the weight and consistency of the interaction of specialists in the polyprofessional teams. Nevrologicheskiy vestnik imeni V.M. Bekhtereva. 2020;1:30–33. (In Russ.). doi: 10.17816/nb16459

14. Mitikhin VG, Alieva LM, Enikolopov SN. An analytic hierarchy process of body image in mental disorders. Psychiatry (Moscow) (Psikhiatriya). 2015;1(65):29–32. (In Russ.).

15. Yastrebov VS, Mitikhin VG. Estimation of activity and prospective development of psychiatric services on the basis of hierarchic model principles. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2005;105(4):61–67. (In Russ.).

16. Khaiyun SD. Kolichestvennyi analiz sotsial’nykh iavlenii. Problemy I perspektivy. M.: LIBROKOM. 2014.