Development of the International Classification of Functioning, Disability and Health core sets for bipolar disorders: results of an international consensus process

Abstract

Purpose: The International Classification of Functioning, Disability and Health (ICF) is a tool of the World Health Organization (WHO) designed to be a guide to identify and classify relevant domains of human experience affected by health conditions. The purpose of this article is to describe the process for the development of two Core Sets for bipolar disorder (BD) in the framework of the ICF. The Comprehensive ICF Core Set for BD intends to be a guide for multidisciplinary assessment of patients diagnosed with this condition, while the Brief ICF Core Set for BD will be useful when rating aspects of patient’s experience for clinical practice or epidemiological studies. Methods: An international consensus conference involving a sample of experts with different professional backgrounds was performed using the nominal group technique. Various preparatory studies identified a set of 743 potential ICF categories to be included in the Core Sets. Results: A total of 38 ICF categories were selected to be included in the Comprehensive Core Set for BD. A total of 19 ICF categories from the Comprehensive Core Set were chosen as the most significant to constitute the Brief Core Set for BD. Conclusions: The formal consensus process integrating evidence and expert opinion on the ICF led to the formal adoption of the ICF Core Sets for BD. The most important categories included are representative of the characteristics usually associated with BD. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings.

Implications for Rehabilitation

• Bipolar disorder (BD) is a prevalent condition that has a great impact on people who suffer it, not only in health but also in daily functioning and quality of life.

• No standard has been defined so far regarding the problems in functioning of persons with BDs.

• The process described in this article defines the set of areas of functioning to be addressed in clinical assessments of persons with BD and establish the starting point for the development of condition-specific outcome measures.

• Bipolar disorders
• Disability and Health
• International Classification of Functioning
• World Health Organization

Acknowledgements

We would like to thank the working group assistants Dr Antonio Veronese, Ms Ana Sabela Álvarez and Ms Cristina Bostan. We would also like to thank Prof. Jerome Bickenbach, Dr Heinrich Gall and Dr Melissa Selb for their invaluable support during the conference.