Discriminant ability and criterion validity of the HoNOS in Italian psychiatric residential facilities

A. Gigantesco, A. Picardi, G. De Girolamo, P. Morosini

Research output: Contribution to journalArticlepeer-review


Background: The Health of the Nation Outcomes Scales (HoNOS) was developed as an inclusive and comprehensive instrument to assess patient outcomes in 4 main domains: behaviour, cognitive and physical impairment, symptoms and social functioning/context. Concerns about the reliability and validity of the HoNOS have been raised. The aim of this study was to further investigate the discriminatory ability of the HoNOS; criterion validity was also examined. Sampling and Methods: A broad sample of patients with psychotic disorders, admitted to 265 Italian residential facilities, were rated by trained research assistants and local staff on the HoNOS, Global Assessment of Functioning, Life Skills Profile, and Physical Health Index. Discriminant function analysis was used to examine the ability of the HoNOS items to correctly classify patients with positive symptoms, substantial psychosocial impairment or physical disability. The HoNOS criterion validity was also examined. Results: On the whole, the pattern of correlations between the HoNOS and the other corresponding measures was consistent. However, the majority of the correlations were only moderate. In discriminant function analysis, the classification procedure correctly classified 55.7% of the patients. Conclusions: Although the HoNOS has many advantages in its brevity, it may lack sufficient discriminatory ability for certain patient groups. Further, it correlates only moderately with measures of disability and physical health status. These findings suggest that the HoNOS alone might be insufficient for routine evaluation and should probably be supplemented by additional measures.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
Issue number2
Publication statusPublished - Feb 2007


  • Discriminant power
  • Health of the Nation Outcome Scales
  • Outcome assessment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)


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