Caregiving in severe mental illness: the psychometric properties of the Involvement Evaluation Questionnaire in Portugal

A Portuguese translation of the IEQ-EU was developed according to the 'European Psychiatric Services: Inputs Linked to Outcome Domains and Needs' (EPSILON) group guidelines. We then studied 194 caregivers who were related to patients with schizophrenia spectrum disorders in psychiatric outpatient services. All relatives were assessed using the IEQ-EU. In order to describe the corresponding patients' sample, the majority (n = 162) was evaluated with the World Health Organization Disability Assessment Schedule (WHO-DAS II); 108 patients were also assessed with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF).The factor structure of the Portuguese version of the questionnaire was similar to the original; internal consistency was good, with Cronbach's α ranging from 0.71 to 0.87 in the IEQ-EU scales (total score and domains: tension, supervision, worrying, urging); test-retest reliability yielded intraclass correlation coefficients (ICCs) from 0.80 to 0.94, concerning the same scores. Ecological validity was confirmed. Most caregiving consequences were reported on the worrying domain of the IEQ-EU.Validity and reliability of the Portuguese IEQ-EU translation were established. Specifically the four IEQ-EU subscale domains seem to be valid in Portugal.Despite huge amounts of high-quality research related to caregiving in severe mental illness (see for example [1-4]), a need exists for the crosscultural validation of caregiver instruments, and for the development of national norms regarding assessments. Without better knowledge of the intercultural validity of measures and local standards, international comparisons will be undermined by doubts regarding the origin of differences between scorings (for example, sampling vs real cultural differences) [5].The European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) study was a crossnational, cross-sectional survey [6,7], which compared characteristics, needs an