It takes only 5 minutes to assess disability in patients with depression

A research team has tested the utility of the short version of WHO-DAS II, a tool to assess within five minutes disability in patients with depression, “which in the case of primary care is even more practicable than the long version of the instrument.” In Spain, more than 10% of the population suffer from severe depression.

The family doctor is usually the first to screen an individual who feels depressed. For this reason, training and tools that enable the diagnosis of this illness and the disability associated with it are essential. A new study now certifies the reliability and validity of the 12-item WHO-DAS II, the short version of the World Health Organization scale to assess disability in primary care patients.

Juan Vicente Luciano’s research team, at Parque Sanitario Sant Joan de Déu, in Sant Boi de Llobregat (Barcelona), observed that the psychometric information available in Spain on WHO-DAS II in patients with depression was insufficient: “a significant limitation given the high prevalence of this pathology among patients who consult their family doctor”, he explains to SINC.

The study, published in the Journal of Affective Disorders, has been based on 3,638 primary care patients from 17 Spanish provinces who have suffered “a major first depressive episode “, according to their family doctor.

“Luciano indicates that “the score obtained by patients on the new scale is more capable at predicting the severity of their depression symptoms than the scores obtained in a quality of life instrument used in the same study”.

The authors conclude that the short version of this tool is “as reliable and valid as the full version” in assessing disability in patients with depression, and is even “more suitable” than the long version in the primary care field, given the short time (less than five minutes) it takes to use it.

WHO-DAS II is a tool that assesses functioning and disability in six areas (understanding and communication; ability to get by in their environment; self-care; relationships with others; daily life activities and participation in society). Its psychometric properties have been tested in more than 14 countries and in 16 different languages.

Spain: a depressed country?

Scientific literature shows a high prevalence of mental disorders in Spain. According to a study published in the journal Medicina Clínica in 2006, 19.5% of the population has had a mental disorder at some stage in their life. The most frequent mental disorder is a severe depressive episode, which affects 10.5% of the population.

In 2008, further research on the frequency of depression among primary care patients in six European countries, published in the British Journal of Psychiatry, revealed that Spain has the highest rate of depression in Europe, particularly among women.

The latest data from the World Health Organization (WHO) show that depression affects 121 million people around the world and is the main cause of work-related disability. Although this pathology can be diagnosed and treated effectively in primary care, less than 25% of people affected receive the appropriate treatment.

Juan V. Luciano, José L. Ayuso-Mateos, Ana Fernández, Antoni Serrano-Blanco, Miquel Roca, Josep M. Haro. “Psychometric properties of the twelve item World Health Organization Disability Assessment Schedule II (WHO-DAS II) in Spanish primary care patients with a first major depressive episode”. Journal of Affective Disorders 121:52-58, febrero de 2010.

King et al.: “Prevalence of common mental disorders in general practice attendees across Europe”. British Journal of Psychiatry (2008);192:362-367.

Josep M. Haro, Concepció Palacín, Gemma Vilagut, Montse Martínez, Mariola Bernal, Inma Luque, Miquel Codony, Montse Dolz, Jordi Alonso y el Grupo ESEMeD-España. “Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España”. Medicina Clínica (2006);126(12):445-51.

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