Assessing disability in older patients with schizophrenia: results from the WHODAS-II

The World Health Organization has recently published an instrument to evaluate disability, entitled the World Health Organization Disability Assessment Schedule-Second Version (WHODAS-II). We sought to evaluate its reliability and validity in older patients with schizophrenia. We studied 54 outpatients with schizophrenia and 22 normal comparison subjects. Besides WHODAS-II, we used standardized rating scales to assess positive and negative symptoms, depressive symptoms, cognitive functioning, everyday functioning, and quality of well-being. There was high internal consistency in WHODAS-II item scores and significant test-retest reliability. Patients reported greater disability than normal comparison subjects. Among the patients, disability scores were significantly associated with severity of depressive symptoms and quality of well-being, but not with cognitive performance and everyday functioning. The findings offer strong evidence for reliability and some evidence for validity of the WHODAS-II in older patients with schizophrenia.