Christopher Holmberg1,2, Andreas Gremyr3,4, Jarl Torgerson3, Kirsten Mehlig5. 1. Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens Backe, Box 457, 405 30, Göteborg, Sweden. christopher.holmberg@gu.se. 2. Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden. christopher.holmberg@gu.se. 3. Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden. 4. Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden. 5. School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Abstract
BACKGROUND: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a self-administered instrument to assess functional impairment. It is used in the general population as well as different patient groups. However, its application to patients with psychotic disorders may be hampered by disease-specific difficulties of self-estimation. This study aimed to examine the psychometric properties of the short (12-item) WHODAS-2.0 in a naturalistic sample of outpatients attending a psychosis clinic in Gothenburg, Sweden. METHODS: Annual data from two outpatient clinics registered 2016-2019 were analyzed retrospectively. The assessment of the short WHODAS-2.0 was based on the first questionnaire completed by 881 patients. Confirmatory factor analysis evaluated previously validated models. Item convergent and discriminant validity as well as internal reliability were computed. Construct validity was assessed by comparing mean differences in accord with previous research regarding patients' characteristics associated with functioning such as advanced age, diagnosed comorbidities, antipsychotic treatment status, and symptom severity measured with PANSS-8 remission items. RESULTS: A heterogeneous sample was obtained in terms of age (range: 20-92), various living situations, and different geographic areas of birth. Most patients (75%) had been diagnosed with psychotic disorders more than 10 years ago and the majority (89%) were on antipsychotic medication. We confirmed an adjusted two-level factor model with a single second-order disability factor and six first-order factors representing the six IFC dimensions. The WHODAS-2.0 sum score measuring general disability showed good reliability (Cronbach's alpha = 0.89). Construct validity was confirmed as older patients, patients with comorbidities, and patients in assisted living had higher WHODAS-2.0 scores. Patients with no or mild psychotic symptoms had significantly lower WHODAS-2.0 sum scores than patients with more severe symptoms. CONCLUSIONS: The findings further validate the 12-item WHODAS-2.0 in a naturalistic sample of outpatients with psychotic disorders. This study corroborates the clinical significance of the short, 12-item WHODAS-2.0 by demonstrating consistent associations between patients' age, medical comorbidities, living situation, antipsychotic treatment status, and psychotic symptom severity.
BACKGROUND: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a self-administered instrument to assess functional impairment. It is used in the general population as well as different patient groups. However, its application to patients with psychotic disorders may be hampered by disease-specific difficulties of self-estimation. This study aimed to examine the psychometric properties of the short (12-item) WHODAS-2.0 in a naturalistic sample of outpatients attending a psychosis clinic in Gothenburg, Sweden. METHODS: Annual data from two outpatient clinics registered 2016-2019 were analyzed retrospectively. The assessment of the short WHODAS-2.0 was based on the first questionnaire completed by 881 patients. Confirmatory factor analysis evaluated previously validated models. Item convergent and discriminant validity as well as internal reliability were computed. Construct validity was assessed by comparing mean differences in accord with previous research regarding patients' characteristics associated with functioning such as advanced age, diagnosed comorbidities, antipsychotic treatment status, and symptom severity measured with PANSS-8 remission items. RESULTS: A heterogeneous sample was obtained in terms of age (range: 20-92), various living situations, and different geographic areas of birth. Most patients (75%) had been diagnosed with psychotic disorders more than 10 years ago and the majority (89%) were on antipsychotic medication. We confirmed an adjusted two-level factor model with a single second-order disability factor and six first-order factors representing the six IFC dimensions. The WHODAS-2.0 sum score measuring general disability showed good reliability (Cronbach's alpha = 0.89). Construct validity was confirmed as older patients, patients with comorbidities, and patients in assisted living had higher WHODAS-2.0 scores. Patients with no or mild psychotic symptoms had significantly lower WHODAS-2.0 sum scores than patients with more severe symptoms. CONCLUSIONS: The findings further validate the 12-item WHODAS-2.0 in a naturalistic sample of outpatients with psychotic disorders. This study corroborates the clinical significance of the short, 12-item WHODAS-2.0 by demonstrating consistent associations between patients' age, medical comorbidities, living situation, antipsychotic treatment status, and psychotic symptom severity.
Authors: T Bedirhan Ustün; Somnath Chatterji; Nenad Kostanjsek; Jürgen Rehm; Cille Kennedy; Joanne Epping-Jordan; Shekhar Saxena; Michael von Korff; Charles Pull Journal: Bull World Health Organ Date: 2010-05-20 Impact factor: 9.408
Authors: Angelica P Herrera; Shedra Amy Snipes; Denae W King; Isabel Torres-Vigil; Daniel S Goldberg; Armin D Weinberg Journal: Am J Public Health Date: 2010-02-10 Impact factor: 9.308
Authors: Maria Brink; Anders Green; Anders Bo Bojesen; J Steve Lamberti; Yeates Conwell; Kjeld Andersen Journal: Schizophr Res Date: 2018-12-06 Impact factor: 4.939
Authors: Gavin Andrews; Alice Kemp; Matthew Sunderland; Michael Von Korff; Tevik Bedirhan Ustun Journal: PLoS One Date: 2009-12-17 Impact factor: 3.240
Authors: Andrea Fagiolini; Paola Rocca; Serafino De Giorgi; Edoardo Spina; Giovanni Amodeo; Mario Amore Journal: Psychiatry Res Date: 2016-11-28 Impact factor: 3.222