Readability of English-Language Self-Report Measures in Bipolar Disorder.

Area of Science:

• Psychiatry
• Clinical Psychology
• Health Literacy

Background:

• Self-report measures are crucial for evaluating mania and depressive symptoms in bipolar disorder.
• The American Medical Association recommends a 5th- to 6th-grade reading level for patient evaluations.
• Previous research indicates psychiatric questionnaires often exceed recommended readability levels.

Purpose of the Study:

• To assess the overall readability of self-report measures for bipolar disorder.
• To determine the readability of both the instructions and item sections of these measures.

Main Methods:

• Nine English-language bipolar disorder assessment measures were identified through literature searches.
• Readability was analyzed using four validated formulas: Gunning Fog, SMOG, FORCAST, and Flesch Reading Ease.
• Measures with an average readability above 6.00 were considered to exceed the recommended level.

Main Results:

• All analyzed measures contained at least one section (instructions or items) written above the recommended reading level.
• The mean readability for instructions was 9.35 (SD = 1.45), and for items was 8.78 (SD = 1.73).
• Individual measures ranged from 5.59 to 11.51 in readability.

Conclusions:

• The elevated reading level of bipolar disorder self-report measures may impede accurate symptom identification in individuals with low reading literacy.
• Utilizing these tools with patients who have lower reading comprehension than the measure's readability may not enhance the diagnostic process.
• Improving the accessibility of these measures is essential for equitable and effective bipolar disorder diagnosis.