Clinical computer applications in mental health

Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) as a measure of treatment effectiveness with psychiatric inpatients

Assessment procedures to evaluate inpatient treatment effectiveness can provide information to inform clinical practice. The Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) represents a standardized approach to assess patients' target problems that combines elements of individualized and nomothetic approaches. Although previous evaluations of CASPER with other patient populations have been encouraging, its use as a measure of change with an inpatient population has not been examined. In this study, 75 psychiatric inpatients completed CASPER and the Behavior and Symptom Identification Scale-32 (BASIS-32) at hospital admission and discharge. Results supported the concurrent validity of CASPER as a measure of pre- and posttreatment functioning and suggested that CASPER may provide a sensitive measure of change during inpatient treatment. Findings also supported the notion that patients' ratings of the extent to which their treatment focused on the problems they identified as a high priority were related to their overall treatment satisfaction.

Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) interview with a psychiatric inpatient population

The Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER; Farrell & McCullough-Vaillant, 1996) includes a computer-based interview designed to assess functioning across a broad range of areas. The psychometric properties of scales derived from this interview were examined in a sample of 191 patients from the admissions wards of a state psychiatric hospital. Few participants had difficulty completing the computerized interview, and most rated their reactions to it positively. Item analyses and confirmatory factor analysis largely replicated the structure reported in a previous study of outpatients. Support was found for scales representing Physical Complaints, Worry, Hopelessness, Assertiveness, Hostility/Anger, Thought Problems, Psychotic Symptoms, Substance Use, and Suicidal Thoughts and Behavior. Comparison of scales from the CASPER and the Behavior and Symptom Identification Scale-32 (BASIS-32; Eisen & Culhane, 1999) supported the convergent and discriminant validity of several scales. Support also was found for the CASPER Global Functioning scale. Overall, results supported the use of the CASPER as a valuable tool for assessing inpatient functioning.

[Clinical applications of data processing in psychiatry]

The reduction of computer costs and the introduction of micro- computers have brought about an irreversible change in all the domains of occidental life. Research in the applications of computing in psychiatry has been going on for more than twenty years. The computer can assist the psychiatrist in many areas of his clinical work. This article reviews the applications of computers in domains such as psychological testing, patient interviews, diagnosis, evaluating psychopharmacological and behavioral treatments, evaluating patient progress, education of professionals, and patient and psychic simulation models, simulation which can also be used for education. Problems met when implementing such programs are also discussed; and finally, we explore some avenues of development and make some recommendations.

Evaluation of a computerized drug review system: impact, attitudes, and interactions

A study was carried out across 11 psychiatric and mental retardation, and developmental disabilities facilities to investigate the impact of a computerized drug prescription monitoring system on clinicians' prescribing behavior, knowledge of pharmacotherapy, attitudes toward computers, and the relationships between their attitudes and changes in their prescribing practices. The results document that surveillance systems can improve prescribing practices. The tangible feedback provided by the exception report, although in the form of a surveillance mechanism, also increased user acceptance to computer technology. However, the findings also suggest that user acceptance is not necessarily required to see positive effects, which in environments where clinical and fiscal accountability are paramount, may override some clinicians' concerns. Attention to human factors components may help to alleviate some negativism.