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The EPSILON study of schizophrenia in five European countries: Design and methodology for standardising outcome measures and comparing patterns of care and service costs

  • Thomas Becker (a1), Martin Knapp (a2), Helle Charlotte Knudsen (a3), Aart Schene (a4), Michele Tansella (a5), Graham Thornicroft (a6) and José Luis Vázquez-Barquero (a7)...



There is a lack of cross-national research on care for people with schizophrenia.


To produce standardised European versions of five instruments in key areas of mental health service research in five languages, and to compare data from five European countries regarding patients with schizophrenia and mental health care provision and costs.


Five centres, in Amsterdam, Copenhagen, London, Santander and Verona, participated. Instruments assessing needs, service use, informal carer involvement, quality of life, and service satisfaction were subjected to a conversion procedure including translation, back-translation, focus group discussion and reliability assessment. Patients of local mental health services with a Schedules for Clinical Assessment in Neuropsychiatry diagnosis of schizophrenia were interviewed.


Service provision varied between sites; 404 patients were studied. instrument reliability was found to be good.


The instruments developed were reliable across the range of countries, and will facilitate future comparative health service research.


Corresponding author

Professor Graham Thornicroft, Section of Community Psychiatry (PRiSM), Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF


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Declaration of interest

This study was supported by the European Commission BIOMED-2 Programme.



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The EPSILON study of schizophrenia in five European countries: Design and methodology for standardising outcome measures and comparing patterns of care and service costs

  • Thomas Becker (a1), Martin Knapp (a2), Helle Charlotte Knudsen (a3), Aart Schene (a4), Michele Tansella (a5), Graham Thornicroft (a6) and José Luis Vázquez-Barquero (a7)...


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