Over the past four decades the World Health Organization (WHO) has produced a number of assessment instruments intended for national and cross-cultural psychiatric research. WHO instruments have been tested and used in many collaborative studies, involving more than 100 centres in different parts of the world. This chapter reviews the main WHO instruments for the assessment of:
• disability and burden
• quality of life
• health services and systems
• environment and risks to mental health.
Instruments for qualitative research are also examined, before the principles used in the development of WHO instruments, their translation and their use across cultures and settings are discussed.
The WHO occupies a unique position in the field of healthcare and represents a neutral platform that can be used to bring about international collaboration in research. It has a mandate to promote and conduct research in the field of health and standardise diagnostic procedures and instruments (WHO, 2005). Over the years the WHO has gained experience in the management of international collaborative research projects and has produced reliable methods for their conduct in different cultures and settings (Sartorius, 1989). The development of cross-culturally applicable and reliable methods for the assessment of problems related to mental health has been one of the major activities in the WHO Mental Health Programme. Many of these methods have been described in scientific publications, released for general use and applied in various research projects worldwide (Sartorius, 1993). This chapter outlines the basic characteristics of the main instruments produced and used in the studies coordinated by the WHO Mental Health Programme. The specific characteristics of the instruments described – their format, area of assessment, main users, training requirements and available translations – are summarised in Tables 17.1–17.5. More details about these and other WHO instruments can be found in the catalogue of assessment instruments used in the studies coordinated by the WHO Mental Health Programme (Janca & Chandrashekar, 1993), available from the WHO on request.
Instruments for the assessment of psychopathology
Alcohol Use Disorders Identification Test
The Alcohol Use Disorders Identification Test (AUDIT; Babor et al, 1989) is a brief structured interview aimed at identifying people whose alcohol consumption has become harmful to their health. It consists of ten questions: three on the amount and frequency of drinking, three on drinking behaviour and four on problems or adverse psychological reactions related to alcohol.