Ramklint Mia, Söderberg Per, Tungström Stefan, Nordenskjöld Axel, Hermansson Liselotte
Department of Medical sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.
Psychiatric Research and Development Department, Säter, Sweden.
Nord J Psychiatry. 2023 Apr;77(3):276-281. doi: 10.1080/08039488.2022.2097738. Epub 2022 Jul 14.
The aim of this study was to investigate concurrent validity of the Swedish self-rated 36-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 by comparison with professional Global Assessment of Functioning (GAF) ratings in psychiatric outpatients.
A cross-sectional convenience sample of 444 patients was recruited from their regular psychiatric outpatient settings. The patients filled out the WHODAS 2.0; their clinicians provided clinical information and performed GAF ratings blinded to the patients' assessments. Analyses of correlations, variance components, and ROC curves were performed to investigate the validity of the WHODAS 2.0 through comparison with the GAF. The variance component analyses included working status, psychosocial problems, number of diagnostic groups, and remission status. GAF ratings were separated as total (GAF-T), symptoms (GAF-S), and functioning (GAF-F).
There was significant correlation ( < 0.001) between WHODAS 2.0 total and domain scores and GAF-S, GAF-F, and GAF-T ratings. The correlations varied from = 0.29 to = 0.48, with the highest being between GAF-F rating and WHODAS 2.0 total score. Repeating the analyses for separate diagnostic groups replicated the findings, though not for psychotic, substance-related, and eating disorders. The WHODAS 2.0 showed good ability to distinguish impaired functioning below a fixed GAF-T cut-off of 70 (area under the curve: 0.74-0.78). The explained variance was lower for the WHODAS 2.0 than for the GAF (38.9% vs. 59.2%).
Concurrent validity was found when comparing the Swedish self-administered 36-item version of WHODAS 2.0 with the expert-rated GAF in psychiatric outpatients.
本研究旨在通过与精神科门诊患者的专业功能总体评定量表（GAF）评分相比较，探讨瑞典自评36项世界卫生组织残疾评定量表（WHODAS）2.0的同时效度。
从常规精神科门诊中招募了444例患者作为横断面便利样本。患者填写WHODAS 2.0；其临床医生提供临床信息并进行GAF评分，且对患者的评估结果不知情。通过与GAF比较，进行相关性分析、方差成分分析和ROC曲线分析，以研究WHODAS 2.0的效度。方差成分分析包括工作状态、心理社会问题、诊断组数量和缓解状态。GAF评分分为总分（GAF-T）、症状（GAF-S）和功能（GAF-F）。
WHODAS 2.0总分及各领域得分与GAF-S、GAF-F和GAF-T评分之间存在显著相关性（<0.001）。相关性范围为=0.29至=0.48，其中GAF-F评分与WHODAS 2.0总分之间的相关性最高。对各诊断组重复进行分析得出了相同的结果，但精神病性障碍、物质相关障碍和进食障碍除外。WHODAS 2.0显示出良好的区分功能受损的能力，在固定的GAF-T临界值70以下（曲线下面积：0.74 - 0.78）。WHODAS 2.0的解释方差低于GAF（38.9%对59.2%）。
在精神科门诊患者中，将瑞典自行施测的36项版WHODAS 2.0与专家评定的GAF进行比较时，发现了同时效度。
