Assessment of functioning in patients with schizophrenia and schizoaffective disorder with the Mini-ICF-APP: a validation study in Italy

Abstract

BackgroundThe aim of the study was to evaluate validity of the Italian Mini-ICF-APP (Mini-ICF Rating for Limitations of Activities and Participation in Psychological Disorders) in schizophrenia and related disorders.Methods74 outpatients affected by schizophrenia or schizoaffective disorders attending a University-based community mental health centre were recruited to the study. All participants underwent comprehensive evaluation using standardized instruments to assess clinical, neurocognitive and functional status. Concurrent validity of Mini-ICF-APP was evaluated and compared to severity scores obtained using the Clinical Global Impression-Schizophrenia scale (CGI-SCH), Positive and Negative Syndrome scale (PANSS), Mini Mental State Examination test (MMSE), Brief Assessment of Cognition in Schizophrenia scale (BACS) and Personal and Social Performance scale (PSP). Construct validity was evaluated by comparing scores obtained at Mini-ICF-APP by remitted versus non-remitted patients, and by recovered versus unrecovered patients. Discriminant validity was evaluated comparing scores on Mini-ICF-APP and Subjective Well-being (SWN) scale. Results: the total score and 12 out of the 13 Mini-ICF-APP items correlated significantly with total score at PSP; Mini-ICF-App total score was moreover significantly correlated with total scores at CGI-SCH, PANSS, MMSE, as well as with several BACS items. Total scores obtained at Mini-ICF-APP were significantly higher among remitted and recovered patients. No relevant correlations were found between scores of Mini-ICF-APP and SWN scales.ResultsThe total score and 12 out of the 13 Mini-ICF-APP items correlated significantly with total score at PSP; Mini-ICF-App total score was moreover significantly correlated with total scores at CGI-SCH, PANSS, MMSE, as well as with several BACS items. Total scores obtained at Mini-ICF-APP were significantly higher among remitted and recovered patients. No relevant correlations were found between scores of Mini-ICF-APP and SWN scales.Conclusionthe Italian version of Mini-ICF-APP is a valid instrument for use in evaluating functioning in chronic patients with schizophrenia and related disorders.

Psychometric evaluation of the polish version of the MINI-ICF-APP – a concise measure of limitations on activity and restrictions on participation according to the international classification of functioning, disability and health (ICF) – in people with mental disorders

“…Apart from the obvious, although not convincing, assumption of its face validity, the Mini-ICF-APP validity assessment conducted may be considered only as a slight approximation. As far as criterion validity goes, the results obtained confirm the positive conclusions of other authors [14,15,17,18], which are based on the correlation of the Mini-ICF-APP scores with the results achieved during the application of tools assessing other constructs of functioning and the mental state of the patients studied. Additional Mini-ICF-APP validators used by other authors lead us to a similar conclusion, also with respect to other aspects of professional activity (among other things, employment, work productivity, and the duration of the incapacity for work).…”

“…The results obtained did not differ in their general meaning from the quoted scores obtained while using the original versions of the tool [7] as well as the other language versions -English [15] and Italian [17][18][19].…”

“…Limitations captured with the use of the Mini-ICF-APP were highest in the group with diagnosed schizophrenia and subsequently in the depressive, bipolar, and anxiety groups. In a group of patients with diagnosed schizophrenia and schizoaffective disorders, apart from high inter-rater agreement (ICC > 0.81), Pinna et al [18] confirmed the validity of the Mini-ICF-APP: correlations with greater severity of psychopathological symptoms (according to PANSS, CGI-S), poorer social (according to PSP, SOFAS) and cognitive functioning according to MMSE and the Brief Assessment of Cognition in Schizophrenia (BACS). Patients classified as clinically and functionally non-remittent and non-healing in a 2-year follow-up showed more limitations of activity.…”

“…Uzyskane wyniki nie odbiegały w swej ogólnej wymowie od cytowanych wyników zastosowania oryginalnej wersji narzędzia [7], jak i jego wtórnych wersji językowych -angielskiej [15] i włoskiej [17][18][19].…”

“…Pinna i wsp. [18] na grupie z rozpoznaniem schizofrenii i zaburzeń schizoafektywnych, obok wysokiej zgodności ocen (inter-rater, ICC > 0,81), potwierdzili trafność Mini-ICF-APP: korelacje z większym nasileniem wymiarów psychopatologicznych (według PANSS, CGI-S), słabszym funkcjonowaniem społecznym (według PSP, SOFAS) oraz poznawczym (według Mini-Mental State Examination -MMSE oraz Brief Assessment of Cognition in Schizophrenia -BACS). Więcej ograniczeń sprawności ujawniali pacjenci zakwalifikowani na podstawie dwuletniej obserwacji jako klinicznie i funkcjonalnie nieremitujący oraz niezdrowiejący.…”