Dimensional Assessment with SVARAD in Clinical Practice

Abstract

Findings from our work can be summarised as follows:

• 1. The SVARAD can be successfully adopted in routine clinical practice; it is easy to learn, quick to use (about 3–5 min for each patient), optimised for a busy clinical setting, and well accepted by clinicians, as it requires minimal effort for data interpretation.

• 2. Several SVARAD dimensions were present in many diagnostic DSM-IV TR categories, suggesting that they can act as “trans-diagnostic” descriptors, for example, Apprehension/Fear, Sadness/Demoralisation, Anger/Aggressiveness, Apathy, Impulsivity, and Activation.

• 3. The SVARAD provides generalised psychopathological profiles of major diagnostic categories, according to its ten descriptive dimensions, with dimensional profiles for each DSM-IV TR diagnostic clinical group.

• 4. The SVARAD is useful for exploring dimensional profiles of descriptive psychopathology within individual diagnostic categories. Patients within the same diagnostic category fit the specific DSM-IV or ICD-10 criteria, following a hierarchical exclusion tree; however, SVARAD findings in two large samples of acute inpatients and outpatients suggest that they might differ clinically to a consistent degree within the same category, resulting in slight to moderate differences in presentation according to SVARAD dimensional scores. The dimensional assessment approach, such as by SVARAD, could easily integrate and enrich the classical diagnostic DSM-IV or DSM-5 assessment to provide a more accurate profile of suffering for each patient and lead to more tailored treatments. Multivariate studies are needed to explore further aspects of this kind of dimensional analysis and its limitations, as well as its potential role in optimising personalised psychiatric treatments.