New international tool to evaluate and classify schizophrenia

A group of researchers from the University of Barcelona (UB) and Benito Menni CASM has coordinated the elaboration of a new tool that can be used to evaluate, study and classify schizophrenia internationally. The tool is part of the International Classification of Functioning, Disability and Health (ICF), a framework of reference promoted and assessed by the World Health Organization (WHO) in order to provide a unifying framework to evaluate and describe people’s health. The ICF Core Set for Schizophrenia results from a research study in which patients, families and international interdisciplinary experts have collaborated. The project was closed in Barcelona with a conference that gathered twenty international schizophrenia authorities, who agreed the document that will be used at national and international levels.

Juana Gómez-Benito, coordinator of Behavior research at the Institute for Brain, Cognition and Behavior (IR3C) and professor of Methodology of the Behavioural Sciences at the Faculty of Psychology of the UB, and Emilio Rojo, adjunct director of the Hospital Benito Menni CASM, presented the new tool at the Mundet Campus of the UB.

A tool that enables worldwide communication

ICF is a tool designed and approved by WHO that categorizes people’s health and health-related states considering personal situation and circumstances. According to Gómez-Benito, “it is an instrument that provides a framework to measure health concerning, for instance, diagnosis, patient functioning, disability levels or the reasons to contact health services”. “Moreover —he adds—, it provides a standard language that enables interdisciplinary communication about health and healthcare services all over the world”.

The tool includes a thorough list of remarkable potential factors affecting functional capacity of people who suffer any kind of impairment. There are a total of 1,454 categories that take into account body functions and structures, for example sensory functions and pain or attention capacity; the abilities needed to perform different activities and participate in social life, as well as contextual factors such as education, environment and profession. “The study has selected those categories which are exclusively important to describe schizophrenia from the perspective of every single agent involved in the disease”, affirms Emilio Rojo. Finally, the consensus conference agreed to include ninety-seven categories to describe schizophrenia functionality, and twenty-five categories in the short list.

“It is a framework of reference to evaluate functionality in schizophrenia. At last, there is a standard language available to mental health scientists and professionals. The instrument can be used to design health services, systems and policies, carry out epidemiological studies at international level, evaluate patients’ functionality and apply it to research, among many other applications”, points out Juana Gómez-Benito.

Participation of patients, families and experts

In order to elaborate these documents, the UB research team, together with the ICF Research Branch —the centre responsible for ICF internationally— have taken into account a protocol designed by WHO. The process included systematic literature review, patient and family discussion groups, expert surveys (psychiatrists, psychologists, nurses, social workers, occupational therapists, etc.) and, finally, an international multicentre empirical study that identifies, from a clinical perspective, the most common problems suffered by schizophrenia patients, as well as the environmental factors that affect their health status.

Research activity lead to the consensus conference that took place on 12, 13 and 14 May at WHO Barcelona’s headquarters, in the Hospital de la Santa Creu i Sant Pau. The conference gathered twenty international schizophrenia authorities. On an iterating decision making process, supported by the work developed by small working groups and plenary sessions, experts conclude which ICF categories defined schizophrenia better.