Quality of Life Research

, Volume 19, Issue 1, pp 97–101 | Cite as

Utility of the twelve-item World Health Organization Disability Assessment Schedule II (WHO-DAS II) for discriminating depression “caseness” and severity in Spanish primary care patients

  • Juan V. Luciano
  • José L. Ayuso-Mateos
  • Ana Fernandez
  • Jaume Aguado
  • Antoni Serrano-Blanco
  • Miquel Roca
  • Josep M. Haro
Brief Communication



The 12-item WHO-DAS II was developed to assess the activity limitations and participation restrictions experienced by individuals irrespective of medical diagnosis. In this paper we examine the known-groups’ validity of the instrument by evaluating its ability to discriminate between patients with/without major depression, patients with depression with/without medical comorbidity, and patients with depression with different depression severity.


The participants were 3,615 PC patients from 17 regions of Spain, with a first-time diagnosis of major depressive episode according to the general practitioner. The 12-item WHO-DAS II, the PHQ-9, and a chronic medical conditions checklist were administered during the consultation.


The statistical analyses indicated that the 12-item WHO-DAS II was able to discriminate between patients with/without depression and between those with different depression severity. The ROC analysis revealed that with a cutoff score ≥50, the instrument correctly classified 70.4% of the sample (area under the ROC curve = .76; sensitivity = 71.4%; specificity = 67.6%).


Overall, our results support the discriminant validity of the 12-item WHO-DAS II for major depression, being quite recommendable its use in epidemiological research.


12-item WHO-DAS II Primary health care Depression Disability 



H. Lundbeck A/S funded this study.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Juan V. Luciano
    • 1
    • 2
  • José L. Ayuso-Mateos
    • 3
    • 4
    • 5
  • Ana Fernandez
    • 1
    • 2
  • Jaume Aguado
    • 1
    • 6
  • Antoni Serrano-Blanco
    • 1
    • 2
  • Miquel Roca
    • 2
    • 7
    • 8
  • Josep M. Haro
    • 1
    • 5
  1. 1.Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de DéuSant Boi de LlobregatBarcelonaSpain
  2. 2.RedIAPP
  3. 3.Departamento de PsiquiatríaUniversidad Autónoma de MadridMadridSpain
  4. 4.Servicio de PsiquiatríaHospital Universitario de la PrincesaMadridSpain
  6. 6.Departament de Salut PúblicaUniversitat de BarcelonaBarcelonaSpain
  7. 7.IUNICSUniversitat de les Illes BalearsPalma de MallorcaSpain
  8. 8.Unidad de Psiquiatría y Psicología Clinica – Hospital Juan MarchPalma de MallorcaSpain

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