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).

The preparatory phase of the project included the following studies:

• A systematic literature review was performed to identify aspects of functioning and relevant environmental factors in outcomes based on the literature in BD published from 2000 to2006 using the ICF as a reference.
• A qualitative study (individual interviews with 15 participants with bipolar I and II) was performed to explore the lived experiences of persons with BD with regard to functioning and relevant environmental factors.
• An expert survey was performed to identify relevant aspects of functioning and related environmental factors from the perspective of health professionals worldwide experienced in treating persons with BD (pool of 68 experts from 27 countries worldwide).
• To describe functioning of individuals with BD from the clinical perspective as well as identify relevant environmental factors, a multicentre cross-sectional study with a sample of 128 participants was performed by Barcelona University Hospital Clinic and the Hospital Universitario de la Princesa in Madrid.

The information collected from these preparatory studies was presented at the international consensus conference, a multi-stage, iterative, decision-making and consensus process that took place at the Faculty of Medicine at the Autónoma University of Madrid (Spain) from 13-15 May 2010. At this consensus conference, 21 experts from 14 countries worldwide decided which ICF categories are to be included in the first version of the ICF Core Sets for BD.

38 ICF categories were selected for inclusion in the Comprehensive ICF Core for BD. Out of the 38 Comprehensive ICF Core Set categories, 19 ICF categories were selected for the Brief ICF Core for BD. The Comprehensive ICF Core Sets for BD can be used clinically as a checklist to assess a patient's needs, to formulate intervention goals and to evaluate progress. It can also be used to rate the content validity of health-status measures and, thereby, select appropriate instruments for the specific needs of persons with BD. In the future, the ICF Core Sets may become the new basis not only for the further development of such measures but also for the creation of item banking relevant to persons with BD.

For more information, feel free to contact the ICF Research Branch (Melissa.selb@paranet.ch).

• Comprehensive ICF Core Set for bipolar disorders (Download PDF)
• Brief ICF Core Set for bipolar disorders (Download PDF)