Dear Adriana, could you please specify your question and give as a little bit more information on your project/program? There are indeed many questionnaires or rating scales on functioning. But what do you really mean respectively what are you looking for? physical functioning, social functioning, emotional functioning, familiy functioning, sleep quality, working capacity, etc.?

Thank you for the request to clarify. I should have specified that patients will be people identified by primary care doctors with depression or anxiety, possibly co-morbid with substance use while they also treated for common disorders like diabetes, hypertension, etc. Areas of function include social, occupational, emotional, physical domains. Counselors will be interacting with these patients after their referral from primary care and the psychiatrist will act as a consultant.  

Hi Adriana. Maybe the best scale that you can use it's FAST because includes occupational, neurocognitive, physical, social, leisure time and financial. Functioning Assessment Short Scale. Its was designed for mental health patients.

Thnak you so much Gonzalo, looks short and comprehensive. Have you used it yourself or contributed in testing? if Yes, can you share any lessons learned?

Hi Adriana. I used it in bipolar disorders and schizophrenia for 2 differents studies.  You can apply FAST in 15 minutes...very FAST (hehe). Have a range score from 0 to 72 points...have not cut off point, highest score means worst functoning. Write me to email: [email protected]

Have a look at the CORE. we use it in our DBT programme

The CORE Outcome Measure (CORE-OM)

This is a client self-report questionnaire designed to be administered before and after therapy. The client is asked to respond to 34 questions about how they have been feeling over the last week, using a 5-point scale ranging from 'not at all' to 'most or all of the time'. The 34 items of the measure cover four dimensions:

Subjective well-being

Problems/symptoms

Life functioning

Risk/harm

The responses are designed to be averaged by the practitioner to produce a mean score to indicate the level of current psychological global distress (from 'healthy' to 'severe'). The questionnaire is repeated after the last session of treatment; comparison of the pre-and post-therapy scores offers a measure of 'outcome' (i.e. whether or not the client's level of distress has changed, and by how much).

The CORE Outcome Measure (CORE-OM) was conceived as a non-proprietary measure of psychological distress. Crucially, it was informed by feedback from practitioners as to what they considered to be important to include. Since its development the CORE-OM has been validated with samples from the general population, NHS primary and secondary care, and in older adults.

Two practitioner-completed forms complement the CORE-OM by providing contextual information.

● The Therapy Assessment Form helps to profile the client, their presenting problems/concerns and their pathway into therapy.

● The End of Therapy Form helps to chart the client's pathway through and out of therapy, alongside a range of subjective outcome assessments.

The use of CORE Therapy Assessment and End of Therapy Forms alongside the CORE-OM distinguishes CORE from standalone outcome measures by routinely adding critical contextual detail on the client and the therapy process.

These 3 paper-based tools can be downloaded as forms and used free of charge under the terms of the CORE Copyright.

How is CORE used?

The WHO-DAS 2.0 would be another option - it was identified. Consistent with your logic for wanting to add a measure of function, the WHO also believes that diagnosis and symptom-based measures assess a different dimension of health than measures of function - the WHO-DAS is put forward as a possible GAF replacement in DSM-5 and is the WHO's  main instrument for operationalizing their ICF.

A widely used and accepted measure is the SF-36 which assess eight domains of health related quality of life. The subscales are: vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health.

Perhaps one of this papers may be helpful for you.

Chen TH, Li L, Kochen MM. (2005). A systematic review: how to choose appropriate health-related quality of life (HRQOL) measures in routine general practice? J Zhejiang Univ Sci B 6(9):936-40.

Dronavalli M, Thompson SC. (2015). A systematic review of measurement tools of health and well-being for evaluating community-based interventions. J Epidemiol Community Health 69(8):805-15.

Noben CY, Evers SM, Nijhuis FJ, de Rijk AE. (2014). Quality appraisal of generic self-reported instruments measuring health-related productivity changes: a systematic review. BMC Public Health 2014;14:115.

Reaney MD, Martin C, Speight J. (2008). Understanding and Assessing the Impact of Alcoholism on Quality of Life: A Systematic Review of the Content Validity of Instruments Used to Assess Health-Related Quality of Life in Alcoholism. Patient 1(3):151-63.

• Weisscher N, de Haan RJ, Vermeulen M. (2007). The impact of disease-related impairments on disability and health-related quality of life: a systematic review. BMC Med Res Methodol 2007;7:24.

https://en.wikipedia.org/wiki/SF-36

http://www.sf-36.org/

Thank you so much to all for your thoughtful suggestions. 

Michael, have you or collaborators used questions 9-12 from SF12 independently? 

Dear Adriana, sorry for the delay. This is a good and legitimate question. No, we did not explicitly.

Questions 9 to 11 refer to emotional well-being. Question 12 is a summary or final question, like others we often use additionally to existing questionnaires. You can use item 12 seperately.

If you want to use questions 9 to 11 seperately, I would recommend you the WHO-5 questionnaire, which is a widley used and accepted questionnaire and which is also used for depression screening. The big advantage over classical or conventional  depression questionnaires is that the items are worded positively. It asks the patients what's good and not what's wrong.

This is a problem with SF-36: Questions 9 (Have you felt calm and peaceful?) and question 10 (Did you have a lot of energy?) are positively worded and question 11 asks negatively (Have you felt downhearted and blue?).This means that for the different items the score has different meanings. A score "1" in question 9 or 10 means best emotional well-being (all the time good mood) but a score "1" in question 11 means worst well-being (all the time depressed).

Kind regards, Michael

https://www.psykiatri-regionh.dk/who-5/Pages/default.aspx

Michael this is EXTREMELY helpful! Thank you

Adriana