Schizophrenia is a severe psychotic disorder characterized by a chronic and relapsing course with generally incomplete remissions, substantial functional decline, frequent psychiatric and medical co-morbidities and increased mortality. Schizophrenia is also associated with an enormous economic burden, the largest component of which derives from lost productivity. Global burden of disease analysis shows that schizophrenia is ranked among the top-ten leading causes of disease-related disability in the world.
Functioning and disability is increasingly being taken into account in assessing the impact of schizophrenia on the individual, as well as the effectiveness of treatments. Difficulties with everyday activities and low health-related quality of life have consistently been reported as being related to schizophrenia. There is also evidence that the level of impairment in individuals with schizophrenia is closely linked to the support provided by different aspects of the environment, not only the family and the community, but also social services, systems, and policies. The ICF offers a common framework for collecting data on functioning and disability of persons living with schizophrenia. To make the ICF with 1400+ categories more practical for routine use, ICF Core Sets have been developed for several health conditions including some mental disorders i.e. depression and bipolar disorders. An ICF Core Set has yet to be developed for schizophrenia. In 2013, the University of Barcelona and the ICF Research Branch together with a corsortium of researchers in Spain, the Netherlands and the United States have taken on the task of developing an ICF Core Set for schizophrenia.
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Functioning is increasingly being taken into account when assessing the impact of bipolar disorder (BD) on the individual as well as on the effectiveness of treatment. However, the studies published on the measures assessing functioning, disability, and/or quality of life in relation to BD show little standardization in the use of these instruments. In addition, these instruments typically cover only selected aspects of the entire experience associated with BD; it is also important to note that no BD-specific instruments exists to date. It would, therefore, be valuable for clinical practice and research to have a practical tool that covers the typical spectrum of problems in functioning of individuals with BD. The project "Developing the ICF Core Sets for BD " begun in the summer of 2007 as a collaboration between the ICF Research Branch, the Autónoma University of Madrid, the World Health Organisation (WHO), the Bipolar Disorder Programme at the Institute of Neurosciences at the Barcelona University Hospital Clinic, the European Bipolar Research Network and the International Society for Bipolar Disorders (ISBD) and the International Society of Physical Medicine and Rehabilitation (ISPRM).
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Depression is associated with significant loss of quality of life, increased morbidity and mortality and enormous economic burden, the largest component of which derives from lost work productivity. Global Burden of Disease analysis shows that unipolar depressive disorders are ranked as the fourth leading cause of burden among all diseases. By 2020, the burden of depression is expected to increase to 5.7% of the total burden of disease, becoming the second leading cause of global disability-adjusted life years lost. Functioning is increasingly taken into account for the diagnoses of depression as well as for evaluating the effectiveness of treatments. The American Psychiatric Association included the concept of functioning as diagnostic option for assessing major depressive disorder in the 4th edition of its Diagnostic and Statistical Manual of Mental Disorders.
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