The construction and validation of the Assessment of Mental Health Related Quality of Life (PsyQoL) instrument

心理健康是国家健康优先领域之一，也是造成疾病负担的最大因素之一。世卫组织的预测表明，到2020年，仅抑郁症的负担就将仅次于心血管疾病。治疗精神障碍的新疗法正在开发中，必须对其进行评估。目前的研究方法不能准确地将这些疗法的成本效益与其他医疗服务的成本效益进行比较，因为这需要衡量“效用”或“生活质量”。到目前为止，开发的为数不多的“通用”“生活质量工具”对不同疾病的“敏感度”差异很大--它们检测变化的能力--没有一种对心理健康状态的变化非常敏感。目前的项目就是为了克服这一赤字。这将通过改进和扩展澳大利亚开发的一种工具--生活质量评估(AQOL)工具来实现。这是迄今为止唯一一种既使用正确的心理测量学原理构建的工具，又根据对患者在社会环境中发挥作用的能力的影响来描述健康状态的工具。这项名为“心理健康量表”的新工具将在现有工具中加入心理健康“模块”，并对现有项目进行修订，从而提高工具的敏感性。所使用的方法将包括在描述健康状况和推导效用分数方面的几个方法创新。该项目将包括一项大规模的“验证”研究，其中将包括建立人群的“常模”，以及在心理质量和其他工具得分之间建立“交换率”。该项目的意义在于，心理生活质量将允许对健康状态进行有效和可靠的测量，在心理干预和其他与健康相关的干预措施之间创造一个“公平的竞争环境”。

Mental Health is one of the national health priority areas as well as one of the largest contributors to burden of disease. WHO projections suggest that by 2020 the burden of depression alone will be second only to cardiovascular disease. New treatments for mental disorders are being developed which must be evaluated. Current research methods do not allow an accurate comparison of the cost effectiveness of these therapies with the cost effectiveness of other medical services as this requires the measurement of 'utility' or 'quality of life'. The small number of 'generic' 'quality of life instruments' developed to date vary significantly in their 'sensitivity' to different illnesses-their ability to detect change-and none is very sensitive to changes in mental health states. The present project is to overcome this deficit. This will be achieved by refining and expanding an instrument developed in Australia, the Assessment of Quality of Life (AQoL) instrument. This is the only instrument to date which was both constructed using correct psychometric principles of instrument construction and which describes health states in terms of the effect upon a patient's ability to function in a social environment. The new instrument called the PsyQoL will increase instrument sensitivity by including a mental health 'module' to the existing instrument and revising existing items. The methods used will include several methodological innovations in the description of health states and the derivation of utility scores. The project will include a large scale 'validation' study which will include the construction of population 'norms' and also the creation of 'exchange rates' between the PsyQoL and other instrument scores. The significance of the project is that the PsyQoL will allow valid and reliable measurement of health states in a way that creates a 'level playing field' between mental and other health related interventions.