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BackgroundThe World Health Organization Disability Assessment Schedule (WHODAS 2.0) measures disability due to health conditions including diseases, illnesses, injuries, mental or emotional problems, and problems with alcohol or drugs.MethodThe 12 Item WHODAS 2.0 was used in the second Australian Survey of Mental Health and Well-being. We report the overall factor structure and the distribution of scores and normative data (means and SDs) for people with any physical disorder, any mental disorder and for people with neither.FindingsA single second order factor justifies the use of the scale as a measure of global disability. People with mental disorders had high scores (mean 6.3, SD 7.1), people with physical disorders had lower scores (mean 4.3, SD 6.1). People with no disorder covered by the survey had low scores (mean 1.4, SD 3.6).InterpretationThe provision of normative data from a population sample of adults will facilitate use of the WHODAS 2.0 12 item scale in clinical and epidemiological research.

The development and psychometric testing of the new World Health Organization (WHO) disablement screening instrument for the general population is described. Two samples were used for the empirical tests: the cross‐cultural sample of the WHO Disablement Assessment Schedule (WHO‐DAS II) field tests in 19 countries (N = 1323), and an Ontario (Canada) general population sample (N = 802). Psychometric tests included procedures from classical test theory as well as analyses based on item response theory (IRT), both parametric and non‐parametric. Results showed that the disablement screener had good properties with respect to classical test theory, but lacked compatibility with respect to IRT criteria. This lack of compatibility with IRT criteria generally leads to a test that must be redefined for each new sample and each time it is administered. Hence, the results reported in this paper suggest that the WHO disablement screener needs revision, if it is to serve as an international cross‐cultural instrument. Copyright © 1999 Whurr Publishers Ltd.

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Summary:We briefly describe the Global Burden of Diseases (GBD) study, its goals, and some of its outcomes as related to neurologic and psychiatric disorders. The summary measure of population health DALYs (Disability Adjusted Life Years) are described, as well as the implications for neuropsychiatric disorders of changing health indicators and the move from mortality toward disability indicators. The pressing need for new measures for health is answered by the new WHO Classification of Functioning Disability and Health, ICF, and a brief summary of its basic principles is provided. Although a better understanding of the physical, social, and economic burden of epilepsy has moved this disorder higher on the world's agenda, epilepsy still has problems to be recognized as a public health priority. The implications of a shift toward considering the disability of epilepsy, as outlined in the the WHO World Health Report 2001, are important. The burden of epilepsy is high and, for the year 2000, accounts for ∼0.5% of the whole burden of diseases in the world. Key Words: Burden of diseaseDALYs-Classification of Functioning and DisabilityBurden of epilepsy.Policy-makers, their public health partners, and consumers alike seek rational guides to set priorities for health, to evaluate the outcomes of interventions and health care reforms, and to monitor changes over time at local, national, regional, or global levels. Estimation of needs for health services, their costs, and effectiveness requires indicators that go beyond measures of death rates or diagnosis alone and include the "functioning" of people. To respond to this need, the Global Burden of Disease (GBD) study was carried out by the World Bank in collaboration with the World Health Organization (WHO) and the Harvard School of Public Health (1,2). The GBD study was designed to address three main goals:(a) To provide information on nonfatal health outcomes for debates on international health policy, which had until then focused on mortality; (b) To develop unbiased epidemiologic assessments for major disorders; and (c) to quantify the burden of disease with a measure that also could be used for cost-effectiveness analysis.The GBD Study has attracted the attention of policy makers and public health experts alike because it provides a common measure for evaluating and priority setting across a wide range of health problems. This measure, the Disability Adjusted Life Year (DALY), has added "disability" to "mortality" in the evaluation of the burden of disease. The addition of disability has increased the relative importance of noncommunicable diseases, which cause much more disability than mortality. These conditions were invisible in traditional estimates of burden that used mortality-based measures alone. DISABILITY ADJUSTED LIFE YEARS: DALYSDALYs are a health-gap measure that combines information on the impact of premature death and of disability and other nonfatal health outcomes and, being based on a universal measure of time, life years, provides a transprofessio...