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Abstract Background: Alcohol use disorders (AUD) contribute substantially to the global disease and disability burden. The Indian Disability Evaluation and Assessment Scale (IDEAS) has seldom been used to measure disability in those with AUDs. Objectives: To assess the validity of IDEAS to quantify disability among persons with AUDs by measuring the level of agreement between IDEAS and World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0). Materials and Methods: A cross-sectional measurement of disability and quality of life (QoL) measures was carried out among those seeking treatment for AUDs. Correlational analyses and Bland-Altman plot analysis were done to measure the level of agreement between IDEAS and WHODAS2.0. Results: The scores on the WHODAS and IDEAS show statistically significant positive correlation (Rho: 0.435, P = 0.0001) indicating convergent validity. There was a significant level of agreement of disability scores using both tools. The IDEAS score had significant negative correlation with the brief version (WHOQoL BREF-Hindi) measures (Rho: -0.301, P = 0.003) indicating divergent validity. Those with greater severity of AUD had higher IDEAS scores (b = 1.9, P = 0.046). Conclusions: IDEAS scores correlate with disability scores measured with WHODAS 2.0 and QoL assessment using WHOQOL-BREF Hindi in those with AUDs. This instrument can be used to quantify disability and provide socioeconomic compensations to these individuals.

Background: The assessment of disability is an integral part of the management of patients with schizophrenia. The Indian Disability Evaluation and Assessment Scale (IDEAS) is a government-recommended tool used for the assessment and certification of disability in mental illnesses. The literature on the psychometric properties such as reliability and validity of IDEAS for the assessment of disability in schizophrenia patients is relatively scant. Materials and Methods: This was a cross-sectional, observational, descriptive study done in a tertiary health care center catering the rural patients in central India. A hundred male and female treatment-seeking schizophrenia patients, who were in symptom remission, were purposively included in the study. Apart from sociodemographic profile and severity assessment, the disability levels of the patients were assessed using IDEAS as well as the World Health Organisation Disability Assessment Scale version 2.0 (WHODAS 2.0). Results: The mean age of the patients included in the study was 36.6 (±9.11) years. Among the four disability domains in the IDEAS, maximum disability was seen in the work domain, whereas self-care was the least affected domain. Males had a higher disability in work, whereas in the individuals belonging to joint families and rural backgrounds, self-care was significantly affected. Pearson correlation test implied that IDEAS showed good internal consistency (Cronbach's alpha = 0.892) and concurrent validity with the WHODAS 2.0 in the assessment of disability in the study participants. Conclusion: IDEAS is a reliable and valid instrument for the measurement of disability in severe mental illnesses such as schizophrenia.

Background: Schizophrenia and bipolar affective disorder (BPAD) have been identified as two severe mental disorders that are associated with a considerable amount of disability. These disorders create significant impairment in many aspects of an individual's life. Objective: This study was undertaken to compare the disability associated with schizophrenia and bipolar affective disorder (BPAD). Materials and Methods: A descriptive cross-sectional study was carried out among patients with a diagnosis of schizophrenia spectrum disorder (F20.0-F20.9) (n = 30) or BPAD (F30.0-F39) (n = 30) as per the International Classification of Diseases-10. The level of disability was assessed by the Indian Disability Evaluation and Assessment Scale. A semi-structured pro forma was used to assess the sociodemographic and clinical parameters. Results: The level of disability was mild in 17 (56.7%) subjects, moderate in 12 (40%) subjects among patients with BPAD. In Schizophrenia, 20 (66.7%) subjects had a mild disability and 10 (33.3%) had a moderate level of disability. The mean global disability score among patients with BPAD was significantly higher than in those with schizophrenia (7.57 + 2.84) versus 6.93 + 2.94, t = 0.846, P = 0.033. Conclusion: The level of disability among individuals diagnosed with BPAD was higher mostly related to self-care and work-related domain disability.

Background: There is paucity of information on epidemiology of mental disability in India. Objective: The objective of this study was to assess mental disability, and to study the association between sociodemographic and comorbid chronic conditions with mental disability. Materials and Methods: This community-based cross-sectional study was conducted among ≥5 years age group in an urban area attached to a Tertiary Care Medical Institute in Puducherry, India. Mental disability was assessed using Indian Disability Evaluation and Assessment Scale. Chronic morbid conditions and other associated factors were collected using pretested questionnaire. Statistical Analysis: Univariate and multiple logistic regression analysis. Results: About 2537 subjects were covered with a response rate of 94.1%. Overall, the prevalence of mental disability was found to be 7.1% (181/2537). Among them, majority had mild mental disability (151, 83.4%), followed by moderate (21, 11.6%), severe (8, 4.4%), and profound (1, 0.6%) mental disability. Univariate analysis showed that age group status, marital status, education level, occupation, family type, religion, hypertension, joint pain, backache, current smoking, current alcohol use, and conflicts were associated with mental disability (P < 0.05). Multiple logistic regression analysis showed that male gender (adjusted odds ratio [AOR] =2.064), widowed status (AOR = 27.022), separated/divorced status (AOR = 16.674), currently married status (AOR = 18.487), being illiterate (AOR = 4.352), having 1st-10th standard education (AOR = 2.531), being in an unskilled (AOR = 0.287) or semiskilled/skilled occupation (AOR = 0.025), belonging to a nuclear family (AOR = 1.816), and absence of family conflicts (AOR = 0.259) were significantly associated with mental disability compared to their counterparts. Conclusion: Mental disability is more common in this area. Males, lesser education level, skilled or unskilled occupation, nuclear family, and conflicts were associated with mental disability after adjusting other variables. Multicentric cross-sectional analytical studies will explore the mental disability burden and its associated factors at regional or country level.

Background: Disability associated with schizophrenia has an impact on various domains of life. Patients with >40% disability are entitled for getting benefits from the government. The study aimed at assessing the certifiable disability, severity of the disability, and its correlates in patients with schizophrenia. Materials and Methods: Tertiary hospital-based cross-sectional study comprised of 63 patients with schizophrenia fulfilling the selection criteria. The data included sociodemographic and illness variables. Positive and Negative Syndrome Scale, Medication Adherence Rating Scale, and Glasgow Antipsychotic Side-effects Scale were used to assess the symptom severity, treatment adherence, and side effects, respectively. The Indian Disability Evaluation Assessment Scale (IDEAS) was used to evaluate the disability. Data were analyzed using the Statistical Package for Social Sciences software. Results: Majority of the patients (53.7%) had certifiable disability. About 46% of patients had mild level of disability, while 39.7% had moderate level of disability, 1.6% had severe level of disability, and 12.7% had profound disability. The disability was observed to be more in the work, social relationships, and communication domain of IDEAS. There was a strong positive correlation between symptom severity, antipsychotic side effects, and disability. The disability was greater in patients who had a poor medication adherence. Conclusion: Patients with schizophrenia have a significant certifiable disability in all domains of life. Symptomatology, antipsychotic side effects, and medication adherence are important predictors of disability. Preventive and rehabilitative measures should be taken for controlling these modifiable factors which would help in limiting disability. Suitable guidance should be given to avail the disability benefits.

Background: India being located between the Golden Crescent and the Golden Triangle is vulnerable to being both a destination and transit route for opioids, leading to significant clinical and public health burden. This study aimed to assess the disability and internalized stigma among opioid use disorder (OUD) patients. Materials and Methods: This was a cross-sectional, observational, descriptive study conducted in the drug de-addiction center of a tertiary care medical college and hospital in North India in patients with OUDs. Disability among patients with OUDs was measured using the Indian Disability Evaluation and Assessment scale (IDEAS), while stigma was measured using the Internalized Stigma of Mental Illness scale. Results: Among 100 patients with OUD, maximum impairment noted was in interpersonal relationships followed by the work domain. However, the least affected was the self-care domain. The mean total score of internalized stigma was 4.31 ± 0.39. There was a statistically significant correlation between demographic variables with injection drug use and high-risk behavior (r = 0.92, P < 0.01, and 0.883, P < 0.01, respectively). Conclusions: Disability assessment using IDEAS among patients with OUD shows a significant impairment across various domains. The highest degree of disability was found in the interpersonal relationships followed by the work domain. Targeting internalized stigma in patients with OUD can contribute toward reducing the disability associated with it.

The Government of India (GOI) has recommended the use of Indian Disability Evaluation and Assessment Scale (IDEAS) for the assessment and certification of disability in patients with mental illness. Although data are available in terms of internal consistency and construct validity of IDEAS, concurrent validity of IDEAS has rarely been evaluated. The aim was to study the concurrent validity of IDEAS with Global Assessment of Functioning (GAF) and Social and Occupational Functioning Scale (SOFS) in patients with schizophrenia. One hundred and seventy-eight consenting patients with schizophrenia in remission were assessed for disability, functioning, and psychopathology using the IDEAS, SOFS, GAF, and Positive and Negative symptom scale (PANSS) respectively. Mean total PANSS score was 51.3 (standard deviation SD -11.19). Disability (>40%) was present in 84.8% of the sample. All the component scores of IDEAS (self-care, interpersonal activities, communication, and work), total IDEAS score, and Global IDEAS score correlated significantly ( < 0.001) with the three domains of SOFS (adaptive life skills, social appropriateness and communication, and interpersonal relationships) along with the total SOFS score. GAF total score had significant negative correlation ( < 0.001) with all the components of IDEAS, total IDEAS score and global IDEAS score. Higher residual psychopathology was also associated with overall higher disability as assessed by total IDEAS score and Global IDEAS score. This study shows that the GOI-modified IDEAS had good concurrent validity with global and sociooccupational functioning as assessed by GAF and SOFS respectively.

The development of a vocational rehabilitation (VR) program on the Tohono O'Odham Indian reservation is described. The program has been successful in creating employment opportunities on reservations and in rural areas.

Background: From a medical model perspective of substance use disorders (SUDs), opioid use disorders are associated with some degree of disability. This study aimed to assess the disability among patients with opioid use disorders (OUDs) and its relationship with internalized stigma. Methodology: This cross-sectional study assessed patients with SUDs at a tertiary care center. Disability among patients with OUDs was assessed using Indian Disability Evaluation and Assessment Scale (IDEAS) while stigma was measured using Internalized Stigma of Mental Illness Scale (ISMIS). Results: Among 168 patients with OUD, the disability was greatest in the domain of work followed by interpersonal activities. About 48.2% and 3.0% of the participants had moderate and severe disability according to IDEAS. Disability (IDEAS) scores had a robust correlation with the stigma (ISMIS) scores (r = 0.453, P < 0.01). Multiple regression analysis found that internalized stigma (ISMIS score) was an independent predictor of disability among patients with OUDs (β =0.42, P < 0.01). Conclusions: From a medical perspective, OUDs are associated with considerable disability which has significant correlation with internalized stigma. Designing interventions which can target internalized stigma among patients with OUD may help in reducing the disability associated with it.

A qualitative study of 20 caregivers of Aboriginal children with developmental disabilities revealed that caregivers continue to be guided by values rooted in traditional Aboriginal societies where all children were considered gifts of the Creator. The lives of vulnerable children had purpose, they were treated with respect, and the self-growth of the caregiver was connected to care of the child. The needs of young families were supported within a web of relationships in family and community. Disruptions to traditional family relationships began in the colonial era with the negation of Aboriginal culture and spirituality, and continue in many communities in ongoing cycles of trauma exacerbated by rapid change. These ruptures to traditional family life have led to reliance by caregivers on medical, social, and educational services based on Euro-Canadian values regarding developmental disability, which have been rooted in negative concepts since the Enlightenment. This research synthesizes Aboriginal ways of knowing and Western academic inquiry within a conceptual framework guided by a metaphor of \"weaving.\" The intersection of marginality and trauma together with negative attitudes to individuals with developmental disabilities in Canadian society gives insight into the experience of caregivers. Presented in story form, the findings provide an incisive critique of a society that views individuals with developmental disabilities as of less worth than others, and also trace a profoundly disturbing picture of the larger experience of what it is to be Aboriginal in Canada today. The findings also reveal the impact these societal realities have on a very vulnerable group of Canadian children who are disabled at disproportionately high rates.