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ORIGINAL RESEARCH article
Front. Rehabil. Sci.
Sec. Disability, Rehabilitation, and Inclusion
Volume 6 - 2025 | doi: 10.3389/fresc.2025.1556390
This article is part of the Research TopicBridging the Gap: Integrating Performance-Based Measures and Person-Reported Outcomes in Disability EvaluationView all articles
Responsiveness and minimal important differences of common disability measures in people with depression and anxiety disorders
Provisionally accepted
Edimansyah Abdin*
Vanessa Seet
Anitha Jeyagurunathan
Sing Chik Tan
Muhammad Iskandar Shah Mohmad Khalid
Yee Ming Mok
Swapna Kamal Verma
Mythily Subramaniam- Institute of Mental Health, Singapore, Singapore
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The Sheehan Disability Scale (SDS), the World Health Organization Disability Assessment Schedule 2.0 12-item version (WHODAS 2.0), and the Social and Occupational Functioning Assessment Scale (SOFAS) are commonly used disability measures in patients with depression and anxiety disorders. The current study aimed to compare the responsiveness and establish the minimal important differences of the WHODAS 2.0, SDS, and SOFAS in people with depression and anxiety disorders. A total of 308 patients (M=36.1, SD=12.7) recruited from outpatient clinics and completed all measures at both time points were included in the current study. The minimal important difference (MID) was estimated using a triangulation approach while the internal and external responsiveness were evaluated using standardised response mean and receiver operating characteristic curves, respectively. We found that the best MID estimates for the WHODAS, SDS, and SOFAS were 3, 4, and 6 points, respectively. Our internal responsiveness analysis showed that the three disability measures were well responsive in patients with improved or stable PHQ-8 and GAD-7 scores at 6-month follow-up. Meanwhile, the external responsiveness analysis demonstrated that the three disability measures showed adequate responsiveness to improvement, with AUC values of at least 0.7. However, when improvement criteria incorporated MID, only WHODAS was found to be adequately responsive. The results of this study will be a helpful guide for clinicians to track and detect meaningful improvements in patient functioning, ensuring continued high-quality clinical care and management.
Keywords: WHODAS, sofas, sds, responsiveness, mid, Minimal important difference, Depression, Anxiety
Received: 06 Jan 2025; Accepted: 15 Apr 2025.
Copyright: © 2025 Abdin, Seet, Jeyagurunathan, Tan, Mohmad Khalid, Mok, Verma and Subramaniam. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Edimansyah Abdin, Institute of Mental Health, Singapore, Singapore
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