Personal Recovery Self-Report Outcome Measures in Serious Mental Illness: A Systematic Review

Simon FELIX1,2, Kevin-Marc VALERY1, Meryl CAIADA1, Sarah GUIONNET1,2, Antoinette PROUTEAU1,2

1LabPsy UR4139 - Université de Bordeaux, Bordeaux, France
2PĂ´le de psychiatrie adulte - Centre Hospitalier de Jonzac, Jonzac, France

Background. The transformation of mental health services towards both person and recovery-centered care has been defined as a priority by the World Health Organization (WHO, 2021). Yet, it has proven difficult to create recovery-oriented health services that consider users subjectivity and perspectives: there is a need to shift from traditional clinical outcome measures to assess specific personal recovery processes (Slade et al., 2014). Validated self-report outcome measures (Patient Reported Outcome Measures, PROMs) are therefore needed to facilitate the transformation towards recovery-oriented practices and services. Objectives were to identify published measures and analyze their measurement properties using a standardized methodology.

Method. Following the COSMIN guidelines (Prinsen et al., 2018, Mokkink et al., 2017), we conducted a systematic review of personal recovery PROMs in serious mental illness. The MEDLINE, PMC, PsycINFO, PsycARTICLES, PBSC and Scopus electronic databases were searched for articles published between May 2012 and October 2023. Full-text articles from a previous systematic review were also examined. A broad spectrum of psychometric properties was reported and analyzed using standardized criteria. A supplementary content validity analysis was conducted.

Results. 118 studies were included in the review, describing 25 PROMs. Ten of them had not been identified in previous reviews. Quality of evidence was globally poor for most PROM measurement properties. Very little evidence was found for cross-cultural validity, measurement invariance, measurement error and criterion validity. The Recovery Assessment Scale and Questionnaire about the Process of Recovery showed the strongest evidence for sufficient psychometric data on a wide range of measurement properties.

Discussion. Several personal recovery measures are now available. While research is still needed to enhance their validity on some psychometric properties, the current tools appear sufficient to cover most research and clinical needs.