Advertisement
Research Article| Volume 56, ISSUE 6, P507-514, June 2003

Disability in depression and back pain

Evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting

      Abstract

      The World Health Organization Disability Assessment Schedule (WHO DAS II) is a new measure of disability based on the ICIDH-2 model of functioning and disability. This study evaluates the measurement properties of the WHO DAS II in two disorders commonly encountered in the primary care setting. Seventy-three patients with depression and 76 patients with back pain were interviewed at baseline and after 3 months of usual primary care. Internal validity, convergent validity, and responsiveness to change of the WHO DAS II were evaluated. The WHO DAS II had excellent internal validity and convergent validity in the primary care setting. The responsiveness to change of the WHO DAS II was comparable to that of the SF-36. The WHO DAS II appears to be a useful health status instrument for measuring the disability associated with both physical and mental disorders in the primary care setting. This instrument facilitates the use of the ICIDH-2 as a framework for evaluating activity limitations and participation.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Clinical Epidemiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Lerner D.J.
        • Amick B.C.
        • Malspeis S.
        • Rogers W.H.
        A national survey of health-related work limitations among employed persons in the United States.
        Disabil Rehabil. 2000; 22: 225-232
        • Hoffman C.
        • Rice D.
        • Sung H.Y.
        Persons with chronic conditions: their prevalence and costs.
        JAMA. 1996; 276: 1473-1479
        • Wiersma D.
        Measuring social disabilities in mental health.
        Soc Psychiatr Psychiatr Epidemiol. 1996; 31: 101-108
        • Dionne C.E.
        • Von Korff M.
        • Koepsell T.D.
        • Deyo R.A.
        • Barlow W.E.
        • Checkoway H.
        A comparison of pain, functional limitations, and work status indices as outcome measures in back pain research.
        Spine. 1999; 24: 2339-2345
        • Strax T.
        • Grabois M.
        Evaluating pain and disability.
        Phys Med Rehab Clin N Am. 2001; 3: 559-569
        • Dionne C.E.
        • Koepsell T.D.
        • Von Korff M.
        • Deyo R.A.
        • Barlow W.E.
        • Checkoway H.
        Predicting long-term functional limitations among back pain patients in primary care settings.
        J Clin Epidemiol. 1997; 50: 31-43
        • World Health Organization
        ICIDH-2: international classification of functioning and disability.
        World Health Organization, Geneva1999
        • Bickenbach J.E.
        • Chatterji S.
        • Badley E.M.
        • Ustun T.B.
        Models of disablement, universalism, and the international classification of impairments, disabilities and handicaps.
        Soc Sci Med. 1999; 48: 1173-1187
        • Fransen J.
        • Uebelhart D.
        • Stucki G.
        • Langeneggert T.
        • Seitz M.
        • Michel B.A.
        The ICIDH-2 as a framework for the assessment of functioning and disability in rheumatoid arthritis.
        Ann Rheum Dis. 2002; 61: 225-231
        • Chopra P.
        • Couper J.
        • Herman H.
        The assessment of disability in patients with psychotic disorders: an application of the ICIDH-2.
        Aust N Z J Psychiatry. 2002; 36: 127-132
        • Soukup M.G.
        • Vollestad N.K.
        Classification of problems, clinical findings and treatment goals in patients with low back pain using the ICIDH-2 beta-2.
        Disabil Rehabil. 2001; 23: 462-473
        • Gray D.B.
        • Hendershot G.E.
        The ICIDH-2: developments for a new era of outcomes research.
        Arch Phys Med Rehabil. 2000; 12: S10-S14
      1. Epping-Jordan JE, Chatterji S, Ustun TB. The World Health Organization Disability Assessment Schedule II. (WHO DAS II): a tool for measuring clinical outcomes. Oral presentation, NIMH Mental Health Services Research Meeting, Washington, DC, July 2000.

        • Vazquez-Barquero J.L.
        • Vazquez Bourgon E.
        • Herrera Castanedo S.
        • Saiz J.
        • Uriarte M.
        • Morales F.
        • Gaite L.
        • Herran A.
        • Utsan T.B.
        Spanish version of the new World Health Organization Disability Assessment Schedule II (WHO DAS II): initial phase of development and pilot study.
        Actas Esp Psiquiatr. 2000; 28: 77-87
        • Wiersma D.
        • DeJong A.
        • Ormel J.
        The Groningen Social Disabilties Schedule: development, relationship with ICIDH, and psychometric properties.
        Int J Rehabil Res. 1988; 11: 213-224
        • Ware J.
        • Kosinski M.
        • Bayliss M.S.
        • McHorney C.A.
        • Rogers W.H.
        • Raczek A.
        Comparison of methods for the scoring and statistical analysis of SF-36 Health Profile and Summary Measures: summary of the results from the Medical Outcomes Study.
        Med Care. 1995; 33: AS264-AS279
        • Simon G.E.
        • Revicki D.A.
        • Grothaus L.
        • VonKorff M.
        SF-36 summary scores: are physical and mental health truly distinct?.
        Med Care. 1998; 36: 567-572
        • Ormel J.
        • VonKorff M.
        • Ustun T.B.
        • Pini S.
        • Korten A.
        • Oldehinkel T.
        Common mental disorders and disability across cultures: results from WHO Collaborative Study of Psychological Problems in General Health Care.
        JAMA. 1994; 272: 1741-1748
        • Murray C.L.
        • Lopez A.D.
        Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study.
        Lancet. 1997; 349: 1498-1504
        • Schulberg H.C.
        • Katon W.
        Treating major depression in primary care practice: an update of Agency for Health Care Policy and Research Practice Guidelines.
        Arch Gen Psychol. 1998; 55: 1121-1127
        • VonKorff M.
        • Saunders K.
        The course of back pain in primary care.
        Spine. 1996; 21: 2833-2837
        • Ware J.E.
        • Sherbourne C.D.
        The MOS 36-item short-form health survey (SF-36).
        Med Care. 1992; 30: 473-483
        • Lerner D.
        • Amick B.C.
        • Rogers W.H.
        • Malspeis S.
        • Bungay K.
        • Cynn D.
        The Work Limitations Questionnaire.
        Med Care. 2001; 39: 72-85
        • Spitzer R.L.
        • Kroenke K.
        • Williams J.B.
        Validation and utility of a self-report version of the PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire.
        JAMA. 1999; 282: 1737-1744
        • Roland M.
        • Morris R.
        A study of the natural history of back pain.
        Spine. 1983; 8: 141-144
        • Haywood K.L.
        • Garratt A.M.
        • Jordan K.
        • Dziedzic K.
        • Dawes P.T.
        Disease-specific, patient-assessed measures of health outcome in ankylosing spondylitis: reliability, validity and responsiveness.
        Rheumatology (Oxford). 2002; 41: 1295-1302
        • Harb G.C.
        • Heimberg R.G.
        • Fresco D.M.
        • Schneier F.R.
        • Liebowitz M.R.
        The psychometric properties of the Interpersonal Sensitivity Measure in social anxiety disorder.
        Behav Res Ther. 2002; 40: 961-979
        • Shill M.A.
        • Lumley M.A.
        The Psychological Mindedness Scale: factor structure, convergent validity and gender in a non-psychiatric sample.
        Psychol Psychother. 2002; 75: 131-150
        • Cable D.M.
        • DeRue D.S.
        The convergent and discriminant validity of subjective fit perceptions.
        J Appl Psychol. 2002; 87: 875-884
        • Deyo R.A.
        • Diehr P.
        • Patrick D.L.
        Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation.
        Control Clin Trials. 1991; 12: 142S-158S
        • Husted J.A.
        • Cook R.J.
        • Farewell V.T.
        • Gladman D.D.
        Methods for assessing responsiveness: a critical review and recommendations.
        J Clin Epidemiol. 2000; 53: 459-468
        • Kazis L.E.
        • Anderson J.J.
        • Meenan R.F.
        Effect size for interpreting changes in health status.
        Med Care. 1989; 27: S178-S189
        • Norman G.R.
        • Startford P.
        • Regehr G.
        Methodological problems in the retrospective computation of responsiveness to change: the lesson of Cronbach.
        J Clin Epidemiol. 1997; 50: 869-879
        • Spitzer R.L.
        • Williams J.B.
        • Kroenke K.
        • Hornyak R.
        • McMurray J.
        Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study.
        Am J Obstet Gynecol. 2000; 183: 759-769
        • Akashiba T.
        • Kawahara S.
        • Akahoshi T.
        • Omori C.
        • Saito O.
        • Majima T.
        • Horie T.
        Relationship between quality of life and mood or depression in patients with severe obstructive sleep apnea syndrome.
        Chest. 2002; 122: 861-865
        • Simon N.M.
        • Otto M.W.
        • Korbly N.B.
        • Peters P.M.
        • Nicolaou D.C.
        • Pollack M.H.
        Quality of life in social anxiety disorder compared with panic disorder and the general population.
        Psychiatr Serv. 2002; 53: 714-718
        • Williams G.
        • Waterhouse J.
        • Mugarza J.
        • Minors D.
        • Hayden K.
        Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy.
        Eur J Clin Invest. 2002; 32: 831-837
        • Herrell R.
        • Goldberg J.
        • Hartman S.
        • Belcourt M.
        • Schmaling K.
        • Buchwald D.
        Chronic fatigue and chronic fatigue syndrome: a co-twin control study of functional status.
        Qual Life Res. 2002; 11: 463-471
        • Thomas K.S.
        • Muir K.R.
        • Doherty M.
        • Jones A.C.
        • O'Reilly S.C.
        • Bassey E.J.
        Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial.
        BMJ. 2002; 325: 752
        • Nilsdotter A.K.
        • Lohmander L.S.
        Age and waiting time as predictors of outcome after total hip replacement for osteoarthritis.
        Rheumatology (Oxford). 2002; 41: 1261-1267
        • Elliott A.
        • Smith B.
        • Hannaford P.
        • Smith W.
        • Chambers W.
        The course of chronic pain in the community: results of a 4-year follow-up study.
        Pain. 2002; 99: 299
        • Taft C.
        • Karlsson J.
        • Do Sullivan M.
        SF-36 summary component scores accurately summarize subscale scores?.
        Qual Life Res. 2001; 10: 395-404
        • Ware J.E.
        • Kosinski M.
        Interpreting SF-36 sumary health measures: a response.
        Qual Life Res. 2001; 10: 405-413
        • Wilson O.
        • Parsons J.
        • Tucker G.
        The SF-36 summary scales: problems and solutions.
        Soz Praventivmed. 2000; 45: 239-246