DOI: 10.3886/e198102v1
title: WSAS in Norwegian routine mental health care

description: AbstractObjective: This study, the first to assess the reliability and validity of the Work and Social Assessment Scale (WSAS) in Norwegian routine mental health care, examines differences in functional impairment based on sick leave status, psychiatric diagnosis, and sex.<br>Method: Including 3573 individuals from community mental health services (n1= 1157) and a psychiatric outpatient clinic (n2 = 2416), exploratory factor analysis on subsample 1 and confirmatory factor analysis on subsample 2 were utilized to replicate the identified factor structure.<br>Results: EFA supported a one-factor model, replicated by the CFA, with high internal consistency (α = .82, ω = .81). Patients on sick leave reported greater impairments in all aspects of functioning, except for relationships, with the largest effect size observed in the reported ability to work (d = .39). Psychiatric outpatients with major depressive disorder were associated with difficulties in home management, private leisure activities, and forming close relationships. Patients with attention-deficit/hyperactivity disorder reported less impairment than those with other disorders. Patients with personality disorders reported more relationship difficulties than those with PTSD, ADHD, and anxiety. No differences were found in the perceived ability to work between diagnoses. Women had a higher impairment in private leisure activities, whereas men reported more impairment in relationships.<br>Conclusion: The demonstrated reliability and validity suggest that WSAS is a valuable assessment tool in Norwegian routine mental health care. Variations in functional impairment across sick leave status, sex, and psychiatric diagnoses highlight the importance of integrating routine assessments of functional impairment into mental health care practices. Future research should combine WSAS with register data to allow for a broader understanding of treatment effectiveness, emphasizing improvements in functional outcomes alongside symptom alleviation.<br>MethodsThe data used for this study were obtained from a quality assessment project focusing on routine care provided to treatment-seeking adults who were either referred to a psychiatric outpatient clinic by general practitioners or sought help within the community mental health services. All responses were recorded prior to treatment. Data from the psychiatric outpatient clinic were collected between February 2020 and February 2022, and data from the community mental health service were collected between September 2020 and October 2022. There were no specific exclusion criteria, but patients receiving treatment in special units (e.g., patients with obsessive-compulsive disorder, schizophrenia, substance abuse, and retired patients) did not take part in the study. The respondents provided their informed consent to participate and submitted their responses using a web-based portal (checkware.no). This study was approved by the Regional Committee for Medical and Health Research Ethics (REK; reference number 2019/31836) and the Norwegian Centre for Research Data (NSD; reference number 2020/605327). <br><br>The total sample consisted of 3573 outpatients with a mean age of 31.9 years (SD = 11.27) and the majority were women (n = 2312; 65 %). Retired persons (n = 6) were excluded from this study. The total sample consisted of two subsamples. Subsample 1 contained individuals seeking help at the community mental health service (n1 = 1157). This subsample included patients from a low-threshold service (n = 866) and a referral-based service (n = 291). Subsample 2 included individuals referred to a psychiatric outpatient clinic (n2 = 2416).
description: Presence of Common Scales: Work and Social Adjustment Scale (WSAS)
description: Smallest Geographic Unit: Norway