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Assessing the severity of functional impairment of psychiatric disorders: equipercentile linking the mini-ICF-APP and
Stephan T Egger1,2, Godehard Weniger3, Mario Müller3
1Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland. stephan.egger@puk.zh.ch.
Background:
The assessment of functioning and impairment due to psychiatric illness has been acknowledged to be crucial for research and practice. This led to the development of the mini-ICF-APP, which provides a reliable and time-efficient measure of functioning and impairment. Although its use is increasing, it remains unclear how it reflects severity and how change might be interpreted from a clinical perspective.
Methods:
In a clinical sample of 3067 individuals hospitalized for mental health treatment, we used an equipercentile approach to link the mini-ICF-APP with the Clinical Global Impression scale (CGI) at admission and discharge. We linked the mini-ICF-APP sum score to the CGI-S scale and the mini-ICF-APP proportional change between admission and discharge to the CGI-I scale.
Results:
The mini-ICF-APP and CGI scales showed a Spearman correlation of 0.50 (p < .000). CGI-S: "borderline-ill" corresponded to a mini-ICF-APP score 1-2; "mildly-ill" to 3-7; "moderately-ill" to 8-15; "markedly-ill" to 16-24; "severely-ill" to 25-37; and "extremely-ill" to a score ≥ 38. The Spearman correlation between the percentage change of mini-ICF-APP sum score and the CGI-I was 0.32 (p > .000); "no-change" in the CGI-I corresponded to an increase or decrease of 2%; "minimally-improved" to a mini-ICF-APP reduction of 3-30%; "much-improved" to a reduction of 31-63%; "very-much-improved" to a reduction of ≥64% "minimally-worse" to an increase of 3-34% "much-worse" to an increase of 35-67%; and finally "very-much-worse" with an increase of ≥68%.
Conclusions:
Our findings improve understanding of the clinical meaning of the mini-ICF-APP sum score and percentage change in patients hospitalized for treatment.
