Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 8, pp 1347–1354 | Cite as

The reliability, validity, and applicability of an English language version of the Mini-ICF-APP

  • Andrew MolodynskiEmail author
  • Michael Linden
  • George Juckel
  • Ksenija Yeeles
  • Catriona Anderson
  • Maria Vazquez-Montes
  • Tom Burns
Original Paper



This study aimed at establishing the validity and reliability of an English language version of the Mini-ICF-APP.


One hundred and five patients under the care of secondary mental health care services were assessed using the Mini-ICF-APP and several well-established measures of functioning and symptom severity. 47 (45 %) patients were interviewed on two occasions to ascertain test–retest reliability and 50 (48 %) were interviewed by two researchers simultaneously to determine the instrument’s inter-rater reliability. Occupational and sick leave status were also recorded to assess construct validity.


The Mini-ICF-APP was found to have substantial internal consistency (Chronbach’s α 0.869–0.912) and all 13 items correlated highly with the total score. Analysis also showed that the Mini-ICF-APP had good test–retest (ICC 0.832) and inter-rater (ICC 0.886) reliability. No statistically significant association with length of sick leave was found, but the unemployed scored higher on the Mini ICF-APP than those in employment (mean 18.4, SD 9.1 vs. 9.4, SD 6.4, p < 0.001). The Mini-ICF-APP correlated highly with the other measures of illness severity and functioning considered in the study.


The English version of the Mini-ICF-APP is a reliable and valid measure of disorders of capacity as defined by the International Classification of Functioning. Further work is necessary to establish whether the scale could be divided into sub scales which would allow the instrument to more sensitively measure an individual’s specific impairments.


Social psychiatry Occupational functioning Outcome measurement Rating scales 



We wish to thank the staff and patients of the Didcot and Witney Community Mental Health Teams who gave their time for this research. We also thank Helen Morley for her valuable assistance with recruitment.

Conflict of interest

This research was funded by an unrestricted educational grant from Johnson and Johnson. They had no involvement in the design or conduct of the trial or in production of this report. The authors declare no other conflict of interest.


  1. 1.
    Burns T, Patrick D (2007) Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatr Scand 116(6):403–418PubMedCrossRefGoogle Scholar
  2. 2.
    Hensing G, Brage S, Nygård JF, Sandanger I, Tellnes G (2000) Sickness absence with psychiatric disorders—an increased risk for marginalisation among men? Soc Psychiatry Psychiatr Epidemiol 35(8):335–340PubMedCrossRefGoogle Scholar
  3. 3.
    World Health Organisation (2004) The global burden of disease: 2004 update. World Health Organisation, GenevaGoogle Scholar
  4. 4.
    Secker J, Grove B, Seebohm P (2001) Challenging barriers to employment, training and education for mental health service users: the service user’s perspective. J Mental Health 10(4):395–404CrossRefGoogle Scholar
  5. 5.
    Boardman J, Grove B, Perkins R, Shepherd G (2003) Work and employment for people with psychiatric disabilities. Br J Psychiatry 182(6):467–468PubMedCrossRefGoogle Scholar
  6. 6.
    Burns T, Catty J, Becker T, Drake RE, Fioritti A, Knapp M et al (2007) The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial. Lancet 370(9593):1146–1152PubMedCrossRefGoogle Scholar
  7. 7.
    Becker D, Drake RE (2003) A working life for people with severe mental illness. Oxford Scholarship Online, OxfordCrossRefGoogle Scholar
  8. 8.
    Kane J, Canas F, Kramer M, Ford L, Gassmann-Mayer C, Lim P et al (2007) Treatment of schizophrenia with paliperidone extended-release tablets: a 6-week placebo-controlled trial. Schizophr Res 90(1–3):147–161PubMedCrossRefGoogle Scholar
  9. 9.
    Burns T, UK 700 Group (2002). The UK700 trial of intensive case management: an overview and discussion. World Psychiatry 1(3):175–178Google Scholar
  10. 10.
    Garety PA, Craig TKJ, Dunn G, Fornells-Ambrojo M, Colbert S, Rahaman N et al (2006) Specialised care for early psychosis: symptoms, social functioning and patient satisfaction. Br J Psychiatry 188(1):37–45Google Scholar
  11. 11.
    World Health Organisation (2001) International classification of functioning, disability and health. World Health Organisation, GenevaGoogle Scholar
  12. 12.
    World Health Organisation (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organisation, GenevaGoogle Scholar
  13. 13.
    Linden M, Baron S (2005). Das „Mini-ICF-Rating für psychische Störungen (Mini-ICF-P)”. Ein Kurzinstrument zur Beurteilung von Fähigkeitsstörungen bei psychischen Erkrankungen. Rehabilitation 44(3):144–151Google Scholar
  14. 14.
    Linden M, Baron S, Muschalla B (2009) Mini-ICF-APP Mini-ICF-Rating for activity and participation in mental health disorders: a brief instrument for assessing foreign activity and participation in mental health disorders based on the International Classification of Functioning, Disability and Health (ICF) the World Health Organization. Hans Huber, GöttingenGoogle Scholar
  15. 15.
    Wiersma D et al (1988) The Groningen Social Disabilities Schedule: development, Relationship with I.C.I.D.H., and psychometric properties. Int J Rehabil Res 11(3):213–224PubMedCrossRefGoogle Scholar
  16. 16.
    Wiersma DDA, Kraaijkamp H, Ormel J (1990). The Groningen Social Disability Schedule. Manual and Questionnaires, 2nd Version. University of Groningen, Department of Social Psychiatry, World Health OrganizationGoogle Scholar
  17. 17.
    Endicott J, Nee J (1997) Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects. Psychopharmacol Bull 33(1):13–16PubMedGoogle Scholar
  18. 18.
    Overall JE, Gorham DR (1962) The Brief Psychiatric Rating Scale. Psychol Rep 10(3):799–812CrossRefGoogle Scholar
  19. 19.
    Mortimer AM (2007) Symptom rating scales and outcome in schizophrenia. Br J Psychiatry 191(50):s7–s14CrossRefGoogle Scholar
  20. 20.
    Goldman HHSA, Lave TR (1992) Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 149:1148–1156PubMedGoogle Scholar
  21. 21.
    Endicott J, Spitzer RL, Fleiss JL, Cohen J (1976) The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 33(6):766–771PubMedCrossRefGoogle Scholar
  22. 22.
    Hilsenroth MJ, Ackerman SJ, Blagys MD, Baumann BD, Baity MR, Smith SR et al (2000) Reliability and validity of DSM-IV Axis V. Am J Psychiatry 157(11):1858–1863PubMedCrossRefGoogle Scholar
  23. 23.
    Morosini PL, Magliano L, Brambilla L, Ugolini S, Pioli R (2000) Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand 101(4):323–329PubMedGoogle Scholar
  24. 24.
    Juckel G, Schaub D, Fuchs N, Naumann U, Uhl I, Witthaus H et al (2008) Validation of the Personal and Social Performance (PSP) Scale in a German sample of acutely ill patients with schizophrenia. Schizophr Res 104(1–3):287–293PubMedCrossRefGoogle Scholar
  25. 25.
    Priebe S, Watzke S, Hansson L, Burns T (2008) Objective social outcomes index (SIX): a method to summarise objective indicators of social outcomes in mental health care. Acta Psychiatr Scand 118(1):57–63PubMedCrossRefGoogle Scholar
  26. 26.
    Shrout PE (1998) Measurement reliability and agreement in psychiatry. Stat Methods Med Res 7(3):301–317PubMedCrossRefGoogle Scholar
  27. 27.
    Bland JA, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327:307–310CrossRefGoogle Scholar
  28. 28.
    Chong SA, Vaingankar JA, Abdin E, Subramaniam M (2012) Mental disorders: employment and work productivity in Singapore. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/S00127-012-0526-5 Google Scholar
  29. 29.
    Baron S, Linden M (2009) Disorders of functions and disorders of capacity in relation to sick leave in mental disorders. Int J Soc Psychiatry 55(1):57–63PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Andrew Molodynski
    • 1
    Email author
  • Michael Linden
    • 2
    • 5
  • George Juckel
    • 3
  • Ksenija Yeeles
    • 1
  • Catriona Anderson
    • 1
  • Maria Vazquez-Montes
    • 4
  • Tom Burns
    • 1
  1. 1.Social Psychiatry Group, Department of PsychiatryUniversity of OxfordOxfordUK
  2. 2.Research Group Psychosomatic RehabilitationCharité University Medicine BerlinTeltowGermany
  3. 3.Department of Psychiatry and PsychotherapyRuhr University Bochum LWL University Hospital BochumBochumGermany
  4. 4.Department of Primary Care Health SciencesOxfordUK
  5. 5.Department of Behavioral MedicineRehabilitation Centre Seehof, Teltow/BerlinTeltowGermany

Personalised recommendations