Exploring the factor structure of the mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis

Stephan T Egger; Godehard Weniger; Julio Bobes; Erich Seifritz; Stefan Vetter

doi:10.1016/j.rpsmen.2021.11.002

Exploring the factor structure of the mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis

Rev Psiquiatr Salud Ment (Engl Ed). 2021 Oct-Dec;14(4):186-195. doi: 10.1016/j.rpsmen.2021.11.002.

Authors

Stephan T Egger¹, Godehard Weniger², Julio Bobes³, Erich Seifritz², Stefan Vetter²

Affiliations

¹ Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Zurich, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Oviedo, CIBERSAM, Oviedo. Spain. Electronic address: stephan.egger@puk.zh.ch.
² Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
³ Department of Psychiatry, Faculty of Medicine, University of Oviedo, CIBERSAM, Oviedo. Spain.

PMID: 34861928
DOI: 10.1016/j.rpsmen.2021.11.002

Abstract

Introduction: Psychosocial functioning is a key factor determining prognosis, severity, impairment and quality of life in people who have a mental disorder. The mini-ICF-APP was developed to provide a standardised classification of functioning and disability. However, despite its gaining popularity little is known about its structure and performance. This paper examines the structure of the mini-ICF-APP using factor analysis techniques.

Materials and methods: In a clinical sample of 3178 patients, with psychiatric diagnoses from several ICD-10 categories, we analysed internal consistency, item inter-correlations and the factorial structure of the data, with reference to ICD-10 diagnostic categories; Neurocognitive Disorders; Alcohol Use Disorders; Substance Use Disorders; Schizophrenia and Psychotic Disorders; Bipolar Disorder; Major Depressive Disorder; Anxiety Disorders; Personality Disorders; and Neurodevelopmental Disorders.

Results: We found good internal consistency and item inter-correlations (Cronbach alpha=0.92) for the mini-ICF-APP. We were able to identify pivotal domains (flexibility, assertiveness and intimate relationships), which demonstrate sub-threshold influences on other domains. The factor analysis yielded a one-factor model as ideal for the whole sample and for all diagnostic categories. For some diagnostic categories the data suggested a two or three-factor model, however, with poorer fit indices.

Conclusions: The factor structure of the mini-ICF-APP appears to modify according to the main diagnosis. However, a one-factor model demonstrates better fit regardless of diagnostic category. Consequently, we consider the mini-ICF-APP to be a trans-diagnostic measurement instrument for the assessment and grading of psychosocial functioning. The use of the mini-ICF-APP sum score seems to best reflect the degree of impairment in an individual, even taking into account that affected domains may lead to sub-threshold effects on other domains.

Keywords: Análisis factorial; Estructura factorial; Factor analysis; Factor structure; Funcionamiento psicosocial; Mental health; Mini-ICF-APP; Psychiatric disorder; Psychosocial functioning; Salud mental; Trastorno psiquiátrico.

MeSH terms

Alcoholism*
Depressive Disorder, Major*
Humans
Inpatients
Mental Disorders* / diagnosis
Quality of Life