title: Characterization of Disability in Canadians with Mental Disorders Using an Abbreviated Version of a DSM-5 Emerging Measure: The 12-Item WHO Disability Assessment Schedule (WHODAS) 2.0.
abstract: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a disability scale included in Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a possible replacement for the Global Assessment of Functioning Scale (GAF). To assist Canadian psychiatrists with interpretation of the scale, we have conducted a descriptive analysis using data from the 2012 Canadian Community Health Survey-Mental Health component (CCHS-MH).
  
  
  
  The 2012 CCHS-MH was a cross-sectional survey of the Canadian community (n = 23,757). The survey included an abbreviated 12-item version of the WHODAS 2.0. Mental disorder diagnoses were assessed for schizophrenia, other psychosis, major depressive episode (MDE), generalized anxiety disorder (GAD), bipolar I disorder, substance abuse/dependence, and alcohol abuse/dependence.
  
  
  
  Mean scores ranged from 14.2 (95% CI, 14.1 to 14.3) for the overall community population to 23.1 (95% CI, 19.5 to 26.7) for those with schizophrenia, with higher scores indicating greater disability. Furthermore, the difference in scores between those with lifetime and past-month episodes suggests that the scale is sensitive to changes occurring during the course of these disorders; for example, scores varied from 23.6 (95% CI, 22.2 to 25.1) for past-month MDE to 14.4 (95% CI, 14.2 to 14.7) in the lifetime MDE group without a past-year episode.
  
  
  
  This analysis suggests that the WHODAS 2.0 may be a suitable replacement for the GAF. As a disability measure, even though it is not a mental health-specific instrument, the 12-item WHODAS 2.0 appears to be sensitive to the impact of mental disorders and to changes over the time course of a mental disorder. However, the clinical utility of this measure requires additional assessment.
authors.affiliation: University of Alberta, Edmonton, Alberta ksjonnes@ualberta.ca patten@ucalgary.ca.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sjonnesen
authors.affiliation: University of Calgary, Calgary, Alberta.
authors.forename: Andrew G M
authors.initials: AG
authors.lastname: Bulloch
authors.affiliation: University of Calgary, Calgary, Alberta.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Williams
authors.affiliation: University of Calgary, Calgary, Alberta.
authors.forename: Dina
authors.initials: D
authors.lastname: Lavorato
authors.affiliation: University of Calgary, Calgary, Alberta.
authors.forename: Scott
authors.initials: S
authors.lastname: B Patten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
keywords: WHODAS; World Health Organization Disability Assessment Schedule 2.0; descriptive statistics; disability; disability evaluation; mental disorders; population characteristics; psychiatric epidemiology