Reliability of the Term "Serious Mental Illness": A Systematic Review.

IF 3.2
Psychiatric services (Washington, D.C.) Pub Date : 2022-11-01 Epub Date: 2022-07-27 DOI:10.1176/appi.ps.202100661
Lauren Gonzales, Lauren E Kois, Crystal Chen, Laura López-Aybar, Brittany McCullough, Kendra J McLaughlin
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Abstract

Objective: The term "serious mental illness" (SMI) is widely used across research, practice, and policy settings. However, there is no consistent operational definition, and its reliability has not been systematically evaluated. The purpose of this review was to provide a comprehensive qualitative content analysis of "SMI" empirical research, including study and sample characteristics and SMI operational definitions. These data can provide important considerations for how stakeholders conceptualize SMI.

Methods: Systematic review of PsycInfo, PsycArticles, and PubMed databases from January 1, 2015, to December 31, 2019, identified 788 original empirical studies that characterized the sample as having "SMI."

Results: Descriptive content analysis indicated that most studies (85%) provided no operational definition for SMI. Only 15% defined the term, and an additional 26% provided examples of SMI that included only psychiatric diagnostic categories (e.g., SMI, such as schizophrenia). Of the 327 studies that provided any description of SMI, variability was noted regarding whether criteria included any mental health diagnosis (N=31) or only specified diagnoses (N=289), functional impairment (N=73), or any specified duration of symptoms (N=39). Across all studies that characterized samples as having SMI, substantial variability was noted regarding included diagnostic classifications.

Conclusions: Referencing "SMI" is second nature for many stakeholders. Findings suggest that evidence-based practice and policy efforts should weigh the level of research support indicating that the construct and the term "SMI" lacks generalizability. Researchers and stakeholders are encouraged to develop precise and agreed-upon diagnostic language in their efforts to support and advocate for people with mental illnesses.

“严重精神疾病”一词的可靠性:系统回顾。
目的:术语“严重精神疾病”(SMI)在研究、实践和政策设置中被广泛使用。但是,目前还没有统一的操作定义,其可靠性也没有得到系统的评价。本综述的目的是对“SMI”实证研究进行全面的定性内容分析,包括研究和样本特征以及SMI操作定义。这些数据可以为利益相关者如何概念化SMI提供重要的考虑因素。方法:对2015年1月1日至2019年12月31日期间的PsycInfo、PsycArticles和PubMed数据库进行系统综述,确定了788项将样本描述为“重度精神分裂症”的原始实证研究。结果:描述性内容分析表明,大多数研究(85%)没有提供SMI的操作性定义。只有15%的人定义了这个术语,另外26%的人提供了只包括精神病学诊断类别(例如,精神分裂症等重度精神障碍)的重度精神障碍例子。在提供SMI描述的327项研究中,在标准是否包括任何精神健康诊断(N=31)或仅包括特定诊断(N=289)、功能损害(N=73)或任何特定症状持续时间(N=39)方面,注意到可变性。在所有将样本定性为重度精神障碍的研究中,在包括诊断分类方面注意到实质性的可变性。结论:引用“SMI”是许多利益相关者的第二天性。研究结果表明,基于证据的实践和政策努力应该权衡研究支持的水平,这表明“重度精神障碍”的概念和术语缺乏普遍性。鼓励研究人员和利益相关者在支持和倡导精神疾病患者的努力中开发精确和商定的诊断语言。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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