The 12 Item W.H.O.D.A.S. as Primary Self Report Outcome Measure in a Correctional Community Treatment Center for Dually Diagnosed Patients

Abstract

The World Health Organization Disability Assessment Scale (WHODAS) is suggested as a measure of impairment in DSM-5. The measurement of impaired functioning is crucial in the rehabilitation of dually diagnosed, addiction and mental health, patients. This study is the first to look at the use of the 12 item self report WHODAS as the primary outcome in a community correctional treatment facility for dually diagnosed patients.100 (55 male; 73 white, 25 black, 2 hispanic) former inmates, age 36.1 ± 11.1, with psychiatric and addiction diagnoses were treated in an integrated program. The 12 item WHODAS was completed by the patients during the initial evaluation and repeated an average of 11.1 ± 2.7 weeks later. The Clinical Global Impression-Severity Scale (CGI) was completed at the same time by the psychiatrist, independently of the WHODAS. At initial assessment, the CGI showed moderate severity and the WHODAS showed severe disability. CGI and WHODAS were significantly correlated (R 0.48, p < 0.0001). After three months of treatment, both measures improved: CGI with 46 % and WHODAS with 49 %. The CGI showed mild severity and the WHODAS moderate disability. The change in CGI was correlated with the change in WHODAS (R 0.57, p < 0.0001). The WHODAS appears sensitive to clinical improvement related to shortterm treatment of a highly co-morbid dual diagnosis population.