Responsiveness and minimal important differences of common disability measures in people with depression and anxiety disorders.
Edimansyah Abdin, Vanessa Seet, Anitha Jeyagurunathan and 5 others
PMID 40370672WHAT IT FOUND
Among adults with depression or anxiety, the 12-item WHODAS tracked meaningful improvement best.
A 3-point change may be the smallest worth noting. SDS and SOFAS needed 4 and 6 points, but did not track improvement as well under stricter criteria.
Key findings
01In 308 patients who completed baseline and 6-month measures, the best estimated minimal important differences were 3 points for WHODAS, 4 points for SDS, and 6 points for SOFAS.
02WHODAS change scores had the highest accuracy for detecting any improvement (area under the curve 0.76), followed by SDS (0.74) and SOFAS (0.70).
03When improvement had to meet symptom-based thresholds on PHQ-8 and GAD-7, only WHODAS remained adequately responsive.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used a convenience sample from one psychiatric hospital and community clinics in Singapore, so it may not represent other settings. The sample was predominantly Chinese and all measures were administered only in English, limiting generalizability to other ethnic groups or languages. The results apply to people with depression or anxiety disorders and may not apply to other mental health conditions. WHODAS and SDS showed small standardized response means in patients who worsened, so they were poor at detecting deterioration. Self-report scales and interviewer-rated SOFAS may have introduced recall bias and observer bias. The accuracy estimates had wide 95% confidence intervals, so the results are less precise.
Declared interests
The authors declared financial support for the research and/or publication. The study was funded by the Singapore National Medical Research Council under Health Services Research Grant HSRG-MH17Nov0001.
The easy way to misread this
Do not assume the three disability measures are equally responsive. Only WHODAS remained adequately responsive when improvement had to meet symptom thresholds, and WHODAS and SDS showed small standardized response means in patients who worsened.