Psychological tests are often used to make important decisions about a patient’s trajectory. A high-quality test is characterized by norms that allow meaningful interpretation of the raw scores....Show morePsychological tests are often used to make important decisions about a patient’s trajectory. A high-quality test is characterized by norms that allow meaningful interpretation of the raw scores. With normed scores an individual’s performance can be evaluated properly by taking into account the influence of relevant individual characteristics, such as age, gender, education level or socio-economic status. From several norming techniques, regression-based norming has proven to be most efficient one and especially useful when including more than one demographical predictor variable. Recently, the R package GAMLSS has been proposed as a framework for this technique. It is an exhaustive family of flexible models that may fit a wide variety of empirical data. This research investigated the performance of GAMLSS compared to traditionally used approaches of multiple regression-based norming. Both techniques were applied to data of the Brief-Symptom Inventory, which was collected in a sample representative of the Dutch population (N = 1662). Age and gender were taken into account as normpredictors. The approaches showed very high correspondence, expect for a deviation of GAMLSS-based scores in the lower score ranges. None of the two approaches was able to properly capture the relationship between raw scores and age. GAMLSS-based norms did not outperform the regression-based approach. They can be considered equally suitable but in practice the complexity of the GAMLSS approach makes it less convenient. However, its flexibility could be advantageous when applied to tests that are heavily dependent on continuous norm predictors.Show less
Waiting time for treatment in Dutch mental healthcare is increasing. General practitioners substantially deviate from the allocation guideline which seems to contribute to the increase of waiting...Show moreWaiting time for treatment in Dutch mental healthcare is increasing. General practitioners substantially deviate from the allocation guideline which seems to contribute to the increase of waiting time. This study aimed to investigate whether undertreatment can be beneficial for patients and the MHC system. In addition, this study aimed to identify characteristics of undertreated patients that suffered unfavorable undertreatment based on clinical data and clinical judgement by general practitioners. Data was obtained in a naturalistic environment in a mental healthcare institution in the Netherlands and patients received treatment as usual. A total of 6193 electronic patient records were included. Exclusion criteria and missing data left 1057 cases eligible for analyses. A one-way ANOVA and a forward hierarchical binary logistic regression were conducted to investigate both aims. Results showed that undertreatment relates to worse treatment outcomes in comparison to patients in S-MHC. Unfavorable undertreatment was best predicted by waiting time and level of pre-treatment functioning. Longer waiting time is related to the need for more specialized care. Also, lower levels of pre-treatment functioning is related to the need for more specialized care. B-MHC care for undertreated patients must be improved. GPs seem to have valid reason to deviate from the allocation guideline. The allocation guideline could benefit from the addition of variables based on clinical judgement. To provide the care that undertreated patients need, treatment in B-MHC could be prolonged to match outcomes in S-MHC. Another solution could be to limit the negative effects during waiting time for patients.Show less
