BJPsych International · Published 2026-07-21 · DOI 10.1192/bji.2026.10111
Marta del Olmo Rodríguez, Jorge Short Apellaniz, Catalina Paredes Coronel, Marco Antonio Villegas García, Raquel Álvarez-García, Raúl Córdoba, Bernadette Pfang, Enrique Baca-García
Background Patient-reported outcome measures (PROMs) are central to person-centred mental healthcare, yet evidence from large-scale digital implementation in routine psychiatry is limited. Aims To describe demographic characteristics and PROMs outcomes in out-patient mental health services across a multicentre Spanish network, and to analyse associations between PROMs and adherence, medication side-effects, self-harm and suicide attempts. Method A multicentre, cross-sectional study included adults attending out-patient mental health clinics (October 2023–March 2025) and who participated in a digital PROMs (e-PROMs) program. Validated Spanish versions of the World Health Organization-Five Well Being Index (WHO-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Identification Test (AUDIT-C), Drug Abuse Screening Test-10 (DAST-10) and Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) scales were deployed via a patient web portal and integrated into the electronic health record. Associations were examined using univariate tests and multivariate logistic regression. Results Of 73 140 referred patients, 7925 (10.9%) completed PROMs (median age 48 years; 68.8% women). Well-being was low (WHO-5 median 36). Moderately severe–severe depression affected 38.5%, severe anxiety 30.9% and post-traumatic stress disorder (PTSD) risk 42.4%. Substance misuse risk was identified in 7.2% and hazardous drinking in 14.7%. Women reported lower well-being (p < 0.001) and higher severe depression (40.6 v. 34.0%, p < 0.001), severe anxiety (33.1 v. 26.0%, p = 0.003) and PTSD risk (45.2 v. 36.1%, p = 0.002). Men had higher substance misuse (9.7 v. 6.0%, p = 0.033) and hazardous drinking (16.3 v. 14.0%, p = 0.034). In multivariate models, the strongest predictors of self-harm (odds ratio >2) included severe depression (odds ratio 4.52, p < 0.001), substance misuse (odds ratio 2.38, p < 0.001), PTSD risk (odds ratio 2.29, p < 0.001) and moderate depression (odds ratio 2.27, p < 0.001). The strongest predictors of suicide attempts included all grades of depression (p < 0.001), PTSD risk (odds ratio 2.39, p < 0.001) and substance misuse (odds ratio 2.37, p < 0.001). Risk of alcohol abuse (odds ratio 0.60, p < 0.001) and substance misuse (odds ratio 0.73, p = 0.003) predicted non-adherence. Conclusions Large-scale digital PROMs collection is feasible and clinically informative. PROMs strongly predicted self-harm, suicidality and adherence, supporting their use for early risk detection and measurement-based psychiatric care.
Abstract from DOAJ. Public domain (CC0 1.0).
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Rodríguez, M., Apellaniz, J., Coronel, C., et al. (2026). Association of digital patient-reported outcome measures (PROMs) with clinical outcomes in out-patient mental healthcare: multicentre, cross-sectional study. BJPsych International. https://doi.org/10.1192/bji.2026.10111