The work and social adjustment scale: Reliability, sensitivity and value

Zahra, Daniel; Qureshi, Adam; Henley, William; Taylor, Rod S; Quinn, Cath; Pooler, Jillian; Hardy, Gillian E.; Newbold, Alexandra; Byng, Richard

doi:10.3109/13651501.2014.894072

Cited by 109 publications

(100 citation statements)

References 18 publications

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“…We did not specify a primary clinical outcome measure as the primary aim of this study related to feasibility. Clinical outcome measures collected were: Short Form 36 (SF36);12 Hospital Anxiety and Depression Scale (HADS);13 EQ-5D-5L;14 Work and Social Adjustment Scale (WSAS);15 5-point patient rated Clinical Global Impression Scale (CGI);16 17 Disabilities of the Arm Shoulder and Hand (DASH);18 Functional Mobility Scale;19 Berg Balance Scale;20 Brief Illness Perception Questionnaire (B-IPQ);21 and 10 m timed walk. The CGI was collapsed into two groups: good outcome (ratings of much improved and improved) and poor outcome (ratings of no change, worse or much worse).…”

Section: Methodsmentioning

confidence: 99%

Randomised feasibility study of physiotherapy for patients with functional motor symptoms

Nielsen

Buszewicz

Stevenson

et al. 2016

J Neurol Neurosurg Psychiatry

197

182

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Objective To determine the feasibility of conducting a randomised controlled trial of a specialist physiotherapy intervention for functional motor symptoms (FMS). Methods A randomised feasibility study was conducted recruiting patients with a clinically established diagnosis of FMS from a tertiary neurology clinic in London, UK. Participants were randomised to the intervention or a treatment as usual control. Measures of feasibility and clinical outcome were collected and assessed at 6 months. Results 60 individuals were recruited over a 9-month period. Three withdrew, leaving 29 intervention and 28 controls participants in the final analysis. 32% of patients with FMS met the inclusion criteria, of which 90% enrolled. Acceptability of the intervention was high and there were no adverse events. At 6 months, 72% of the intervention group rated their symptoms as improved, compared to 18% in the control group. There was a moderate to large treatment effect across a range of outcomes, including three of eight Short Form 36 (SF36) domains (d=0.46-0.79). The SF36 Physical function was found to be a suitable primary outcome measure for a future trial; adjusted mean difference 19.8 (95% CI 10.2 to 29.5). The additional quality adjusted life years (QALY) with intervention was 0.08 (95% CI 0.03 to 0.13), the mean incremental cost per QALY gained was £12 087. Conclusions This feasibility study demonstrated high rates of recruitment, retention and acceptability. Clinical effect size was moderate to large with high probability of being cost-effective. A randomised controlled trial is needed. Trial registration number NCT02275000; Results.

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Section: Methodsmentioning

confidence: 99%

Randomised feasibility study of physiotherapy for patients with functional motor symptoms

Nielsen

Buszewicz

Stevenson

et al. 2016

J Neurol Neurosurg Psychiatry

197

182

View full text Add to dashboard Cite

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“…Cronbach’s α measure of internal consistency of WSAS range from 0.80 to 0.94, with test–retest reliability of 0.73. The WSAS also has good convergent and discriminant validity and is sensitive to patient differences in severity, as well as treatment-related change 34,35…”

Section: Methodsmentioning

confidence: 99%

Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder

Jha¹,

Teer²,

Minhajuddin

et al. 2017

NDT

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BackgroundMajor depressive disorder (MDD) significantly impacts performance of both work- and nonwork-related routine daily activities. We have shown that work productivity is significantly impaired in employed MDD patients, but the extent of impairments in nonwork-related routine activities and its association with antidepressant treatment outcomes has not been established.Materials and methodsActivity impairment was measured using the sixth item of Work Productivity and Activity Impairment Scale in the Combining Medications to Enhance Depression Outcomes (CO-MED) trial (n=665). Published norms were used to define activity impairment levels. The relationship between activity impairment and baseline sociodemographic and clinical characteristics was evaluated along with changes in activity impairment and its relationship with other clinical outcomes such as symptom severity, function, and side effect burden. Remission status at 3 and 7 months was predicted based on week 6 activity impairment level.ResultsHigher psychosocial and cognitive impairments and greater number of comorbid medical conditions were associated with greater activity impairment at baseline. Proportion of participants with severe activity impairment declined from 47.6% at baseline to 18.7% at 3 months, while mean activity impairment decreased from 57.1 at baseline to 32.8 at 3 months. During course of treatment, levels of activity impairment correlated most strongly with psychosocial function among measures of symptom severity, function, quality of life, and side effect burden. No or minimal activity impairment at week 6 was associated with two to three times higher rates of remission at 3 and 7 months as compared to moderate or severe activity impairment levels even after controlling for remission status at week 6 and select baseline variables.ConclusionDepressed patients have high levels of nonwork-related activity impairment at baseline that improves significantly with treatment and independently predicts long-term clinical outcomes. Brief systematic assessment of activity impairment during the course of antidepressant treatment can help inform clinical decision-making.

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“…Cronbach’s α measure of internal consistency ranges from 0.80 to 0.94, with test-retest reliability of 0.73. The WSAS also has good convergent and discriminant validity, and is sensitive to patient differences in severity, as well as treatment-related change [38, 39]. …”

Section: Methodsmentioning

confidence: 99%

Early Improvement in Psychosocial Function Predicts Longer-Term Symptomatic Remission in Depressed Patients

et al. 2016

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The goal of this study was to evaluate the relationship between early change in psychosocial function independent of depression severity and longer-term symptomatic remission. Participants of Combining Medications to Enhance Depression Outcomes trial were randomly selected for model selection (n = 334) and validation (n = 331). Changes in psychosocial function (Work and Social Adjustment Scale, WSAS) from baseline to week 6 were assessed and two data-driven sub-groups of WSAS change were identified in the randomly selected model selection half. Results of analyses to predict symptomatic remission at 3 and 7 months were validated for these sub-groups in the second half (validation sample). From baseline to week 6, psychosocial function improved significantly even after adjusting for depression severity at each visit and select baseline variables (age, gender, race, ethnicity, education, income, employment, depression onset before age 18, anxious features, and suicidal ideation), treatment-arm, and WSAS score. The WSAS change patterns identified two (early improvement and gradual change) subgroups. After adjusting for baseline variables and remission status at week 6, participants with early improvement in the second half (validation sample) had greater remission rates than those with gradual change at both 3 (3.3 times) and 7 months (2.3 times) following acute treatment initiation. In conclusion, early improvement in psychosocial function provides a clinically meaningful prediction of longer-term symptomatic remission, independent of depression symptom severity.

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The work and social adjustment scale: Reliability, sensitivity and value

Abstract: The WSAS, PHQ-9 and GAD-7 perform comparably on measures of reliability and sensitivity. The WSAS also measures a distinct social functioning component suggesting it has potential as an additional outcome measure.

Cited by 109 publications

References 18 publications

Randomised feasibility study of physiotherapy for patients with functional motor symptoms

Randomised feasibility study of physiotherapy for patients with functional motor symptoms

Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder

Early Improvement in Psychosocial Function Predicts Longer-Term Symptomatic Remission in Depressed Patients

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