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Assessment of functioning and disability in patients with schizophrenia using the WHO Disability Assessment Schedule 2.0 in a large-scale database

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Abstract

Schizophrenia is a common mental disorder characterized by deficits in multiple domains of functioning. This study is arguably the first of its kind in Taiwan to examine, in a multifaceted and objective manner, the disability of patients with schizophrenia and the factors affecting it. A cross-sectional design was adopted to gather data from 24,299 patients with schizophrenia who were listed in the Taiwan Databank of Persons with Disabilities. The level of disability in these patients was measured using the World Health Organization Disability Assessment Schedule 2.0. Statistical analyses were conducted through the χ 2 statistic and Poisson regression. The highest level of disability was in participation and the lowest was in self-care. An analysis of disability in all six domains of functioning on the basis of sex, age, type of residence, and socioeconomic status (SES) showed significant differences (P < 0.05). Significant factors (P < 0.05) affecting disability in these domains were female gender, age, educational attainment, SES, type of residence, and employment status. The overall degree of disability in schizophrenia patients was moderate. Six domains were measured in this study. The degrees of disability in mobility and self-care were mild while cognition, getting along, life activities, and participation were moderate. Moreover, female gender, an age of 45 or older, low educational attainment, middle to low SES, staying at healthcare institutions, and unemployment were crucial factors affecting disability of the participants. Preventive and rehabilitation programs should be developed to delay disability and functional degeneration in schizophrenic patients with these characteristics.

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Acknowledgements

We thank Kai-Hsiang Chuang for contributing to this study.

Author information

Author notes

  1. Wen-Chou Chi and Kuei-Ru Chou have contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

    Ruey Chen & Kuei-Ru Chou

  2. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Tsan-Hon Liou

  3. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Tsan-Hon Liou & Kwang-Hwa Chang

  4. Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan

    Kwang-Hwa Chang

  5. Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Kwang-Hwa Chang

  6. Department of Public Health, Tzu Chi University, Hualien, Taiwan

    Chia-Feng Yen

  7. Taiwan Society of International Classification of Functioning, Disability and Health, Taipei, Taiwan

    Hua-Fang Liao

  8. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Hua-Fang Liao

  9. Department of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan

    Wen-Chou Chi

  10. Department of Nursing, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Kuei-Ru Chou

  11. Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan

    Kuei-Ru Chou

Authors
  1. Ruey Chen
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  2. Tsan-Hon Liou
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  3. Kwang-Hwa Chang
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  4. Chia-Feng Yen
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  5. Hua-Fang Liao
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  6. Wen-Chou Chi
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  7. Kuei-Ru Chou
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Corresponding author

Correspondence to Kuei-Ru Chou.

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Conflict of interest

The authors declare that they have no competing interests.

Funding

This study was supported by the Ministry of Health and Welfare, Taiwan (Grant Nos. 98M8178, 99M4080, 99M4073, 100M4145, 101M4100, 102M4018, and 103M03F4037).

Ethical approval

Joint Institutional Review Board of Taipei Medical University (Approval Nos. 201004001 and 201205042).

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Cite this article

Chen, R., Liou, TH., Chang, KH. et al. Assessment of functioning and disability in patients with schizophrenia using the WHO Disability Assessment Schedule 2.0 in a large-scale database. Eur Arch Psychiatry Clin Neurosci 268, 65–75 (2018). https://doi.org/10.1007/s00406-017-0834-6

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  • DOI: https://doi.org/10.1007/s00406-017-0834-6

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