Cutoff for Benchmark Disability Using World Health Organization Disability Assessment Schedule 2.0: A Community-Based...

Area of Science:

• Mental Health Research
• Disability Assessment
• Public Health Policy

Background:

• India currently uses the Indian Disability Evaluation and Assessment Scale (IDEAS) to quantify mental illness disability, with a benchmark cutoff of 7.
• India has adopted the International Classification of Functioning and Health (ICF) and is a signatory to the World Health Organization Disability Assessment Schedule (WHODAS).
• A specific cutoff score for benchmark disability using WHODAS in community-based samples is currently lacking.

Purpose of the Study:

• To determine a benchmark disability cutoff score for the World Health Organization Disability Assessment Schedule (WHODAS) in a community-based sample in India.
• To compare the WHODAS cutoff score with the existing Indian Disability Evaluation and Assessment Scale (IDEAS) for quantifying disability in mental illness.
• To assess the feasibility of transitioning from IDEAS to WHODAS for disability evaluation in India.

Main Methods:

• The study was conducted in Jagaluru Taluk, Davanagere District, Karnataka, as part of Indian Council of Medical Research-funded research.
• Data analysis involved descriptive statistics (frequency, percentages, mean, standard deviations, mode, median) and Receiver Operating Characteristic Curve analysis.
• The study included 184 individuals with severe mental illness, with a mean age of 47 years and an average duration of illness of 11 years.

Main Results:

• Participants with severe mental illness exhibited mild disability scores (5.99) on the IDEAS.
• The corresponding cutoff score on the WHODAS, when the influence of duration of illness (DOI) was removed, was determined to be 24.
• This cutoff score of 24 for WHODAS was validated for both hospital and community-based samples after accounting for the undue influence of DOI.

Conclusions:

• A shift from the Indian Disability Evaluation and Assessment Scale (IDEAS) to the World Health Organization Disability Assessment Schedule (WHODAS) for disability assessment in mental illness is feasible in India.
• A WHODAS score of 24 is proposed as the benchmark cutoff for disability in mental illness, irrespective of whether the sample is hospital or community-based, once the influence of duration of illness is removed.