Functionality Assessment

Disability Assessment (WHODAS 2.0)

The DSM-5 includes a specific instrument to assess disability: the WHODAS 2.0.

This tool consists of 12 questions that assess different domains of the person (such as mobility or self-care) based on the difficulty experienced in the past 30 days.

A rating scale ranging from 0 (no difficulty) to 4 (extreme difficulty) is used.

The sum of these scores allows determining the level of difficulty and functionality of the patient, applying only to people with disabilities.

Contextual Factors and Z-Code

The comprehensive assessment should consider factors that affect health beyond pathology.

In ICD-11, this is assessed in Axis 2 (disability in self-care, occupation, family and social function) and Axis 3 (environmental factors such as problems related to childhood, education, housing or employment).

In addition, there is the Z-Code, which is used when a disorder or a set of characteristics are inconclusive to diagnose a specific problem due to lack of information, even though most of the symptoms are present.

Summary

The DSM-5 incorporates the WHODAS 2.0 instrument to assess disability using 12 questions that explore domains such as mobility and self-care during the past thirty days.

A rating scale of zero to four is used to measure the difficulty experienced. The sum total determines the patient's functional level, applied only if disability is present.

The comprehensive assessment considers contextual and environmental factors. The Z-Code is used when, despite symptoms, the information is insufficient to conclude a specific pathological diagnosis.