Validation of the Brazilian Version of WHODAS 2.0 in Patients with Mental Disorders: Should the 12-Item Scale be an Alternative to 36-Item Scale in DSM-5?

Abstract

The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Brazilian version was self-applied in 500 psychiatric and 50 non-psychiatric patients in an outpatient medical centre. The instrument was reapplied in 50 psychiatric patients whose treatment with psychotropics was not altered, and in 100 whose it was altered. Confirmatory factor analysis confirmed the theoretical dimensional model proposed by the WHO for the WHODAS 2.0 36-item scale, and a simpler alternative model for the WHODAS 2.0 12-item scale. All the items of the WHODAS 2.0 was proven to be valid and reproducible for use in people with mental disorders from Brazil. The WHODAS 2.0 scores differentiate psychiatric from non-psychiatric patients and exhibited a significant correlation with the Global Assessment of Functioning scale. However, the 12-item scale was more responsive to changes in the patients' treatment than the 36-item scale, and this should be considered for Diagnostic and Statistical Manual of Mental Disorders.

Validation of the 36‐item and 12‐item self‐report World Health Organization Disability Assessment Schedule II (WHODAS‐II) in individuals with autism spectrum disorder

“…Additional research within a larger sample is needed to confirm findings. We note, however, that these findings are very similar to what has been reported for both clinical and nonclinical populations [e.g., Brasil & Correr, ; Chiu et al, ; Garin et al, ; Luciano et al, ; Moen et al, ; Üstün et al, ]. Fifth, while we did include an independent clinician rating of social functioning, future studies may also wish to include reports from partners and significant others to determine the relationship between self‐report assessment and significant other assessments.…”

“…The internal consistency analysis showed that the summary and different domain scores of the 36-item WHODAS II present adequate internal consistency (α > 0.7). Similar Cronbach's values have been obtained in previous studies with the 36-item version in patients with ASD [Schmidt et al, 2015], bipolar [Guilera et al, 2015], depression [Chwastiak & Von Korff, 2003;Luciano et al, 2010], schizophrenia [Guilera et al, 2012], or other mental disorders [Brasil & Correr, 2018]. All items (except item 4.5 "sexual activity") exhibited satisfactory correlation with their respective domains and summary scores, indicating that the WHODAS-II items can discriminate high-scoring individuals from a lower scoring individual.…”

“…Only one study, that we are aware of, has examined its internal consistency [Schmidt et al, ], showing high internal consistency for the summary score. Several studies have analyzed the psychometric properties of the WHODAS‐II in people with mental health disorders, demonstrating an excellent internal consistency and an adequate construct validity across the subscales [Brasil & Correr, ; Chwastiak & Von Korff, ; Guilera et al, , ; Luciano et al, ]. There has, however, been some debate about whether autistic adults may have greater difficulty reporting their own affective states and impairments [e.g., Volkmar, Lord, Bailey, Schultz, & Klin, ].…”

Validation of the 12‐item World Health Organization Disability Assessment Schedule 2.0 in individuals with schizophrenia, depression, anxiety, and diabetes in Singapore

“…The 12-item version is short, simple, easy to administer in both clinical and general population settings and takes about 5 to 20 minutes to complete. The 12-item version is preferred over the 36-item version and reported to have good internal consistency, discriminant validity, construct validity [4][5][6], and considered more responsive than the 36-item version [7].…”

Development and Validation of a Psychological Scale for Bariatric Surgery: The Baritest

“…At the time of applying BariTest, 175 patients also received two other questionnaires: the WHODAS 2.0 (Annex 1), which is a self-administered questionnaire that measures functionality and disability related to any disease or health status, avoiding the researcher's bias, and the Obesity -related Problems Scale (OP) (Annex 2), which is a scale of outcomes reported by patients that measures the impact of excess weight on psychosocial functioning. These instruments were chosen because they have been validated 4,5 for the Brazilian population with obesity to measure psychological well-being.…”