• Viktor Isjanovski PHI, Health Center Skopje, North Macedonia
  • Andromahi Naumovska PHI, Health Center Skopje, North Macedonia
  • Stojan Bajraktarov University Clinic of Psychiatry, Faculty of Medicine , Ss. Cyril and Methodius University in Skopje, North Macedonia


The main objective of this study was to determine and compare differences in the level of functionality in 180 patients with SMI in WHODAS 2.0 according their demographic characteristics- gender, marriage, education, and professional arrangement/income before establishing Community Based mental healthcare in Skopje, North Macedonia. Results show that on subscale Life activities and Participation selected patients are with lower level of functionality. Results for lower level of functionality are obtained on the subscales Cognition and Mobility, and mild level of disability are obtained on the subscales Getting along and Self-care. The general level of functioning of all examined participants is on moderate level of dysfunctionality.

 Key words:  mental health, demographic characteristics, severe mental illnesses



1. Promoting mental health: concepts, emerging evidence, practice: summary report. Geneva, World Health Organization, 2004.
2. Болнички морбидитет од ментални заболувања во Република Македонија, 1998-2012. Институт за јавно здравје на Република Македонија, Анкета спроведена во соработка со ЦЈЗ. Скопје.
3. Програмата за здравствена заштита на лица со душевни растројства во Р. Македонија за 2013 година. Влада на Република Македонија, 2012.
4. Health 2025: the European policy for health and well-being http://www.euro.who.int/en/what-we-do/health-topics/health-policy/health-2025-the-european-policy-for-health-and-well-being
5. Comprehensive Mental Health Action Plan 2013-2025. WHO, 2013. (http://apps.who.int/iris/bitstream/10665/89966/1/9789241506021_eng.pdf)
6. Националната стратегија за унапредување на менталното здравје во Република Македонија, 2005/2012 година. Национална комисија за заштита на менталното здравје, 2005.
7. WHO-AIMS Report on Mental health System in the Former Yugoslav Republic of Macedonia. WHO, Country Office, Skopje & WHO, Regional Office for Europe, 2009.
8. Murray, C. J., Vos, T., Lozano, R., Naghavi, M., Flaxman, A. D., Michaud, C., & Aboyans, V. (2013). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2197-2223.
9. Gold, L. H. (2014). DSM-5 and the assessment of functioning: the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Journal of the American Academy of Psychiatry and the Law Online, 42(2), 173181.
10. Guerra, M., Ferri, C. P., Sosa, A. L., Salas, A., Gaona, C., Gonzales, V.,& Prince, M. (2009). Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study. The British Journal of Psychiatry, 195(6), 510-515.
11. Gómez, P., Enders, J., Alvarado, R., Cometto, M., & Fernandez, A. (2015). Evaluación del funcionamiento psicosocial de los pacientes con trastorno mental. Revista de la Facultad de Ciencias Médicas, 72(4), 243-249.
12. Lara C, Medina-Mora ME, Borges G, & Zambrano J. (2007). Social cost of mental disorders: Disability and work days lost. Results from the Mexican survey of psychiatric epidemiology. Salud Mental, 30(5), 4-11.
13. Benjet, C., Casanova, L., Borges, G. & Medina-Mora, M. E. (2013). Impacto de los trastornos psiquiátricos comunes y las condiciones crónicas físicas en el individuo y la sociedad. Salud Pública de México, 55(3), 248-256.
14. Romera, I., Perez, V., Menchón, J. M., Delgado-Cohen, H., Polavieja, P., & Gilaberte, I. (2010). Social and occupational functioning impairment in patients in partial versus complete remission of a major depressive disorder episode. A six-month prospective epidemiological study. European Psychiatry, 25(1), 58-65.
15. Velligan, D., Diamond, P., Maples, N., Mintz, J., Li, X., Glahn, D., & Miller, A. (2008). Comparing the efficacy of interventions that use environmental supports to improve outcomes in patients with schizophrenia. Schizophrenia Research, 102(1-3), 312-319.
16. Garin, O., Ayuso-Mateos, J. L., Almansa, J., Nieto, M., Chatterji, S., Vilagut, G., & Racca, V. (2010). Validation of the” World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health and Quality of Life Outcomes, 8(1), 51.
17. Vázquez-Barquero, J. L., Vázquez, B. E., Herrera, C. S., Saiz, J., Uriarte, M., Morales, F., ... & Ustün, T. B. (1999). Spanish version of the new World Health Organization Disability Assessment Schedule II (WHO-DAS-II): initial phase of development and pilot study. Cantabria disability work group. Actas Españolas de Psiquiatria, 28(2), 77-87.
18. Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J. & Pull, C. (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88(11), 815-823.
19.Ertugrul A, Ulug B. The influence of neurocognitive deficits and symptoms on disability in schizophrenia. Acta Psychiatr Scand. 2002; 105:196–201.
20. McKibbin CL, Patterson TL, Jeste DV. Assessing disability in older patients with schizophrenia: result from the WHODAS-II. J Nerv Ment Dis. 2004; 192:405–13.
21. Jablensky A, Satorius N, Emberg G, Anker M, Kortn A, Cooper JE, Day R, Bertelsen A. Schizophrenia: manifestation, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogram Suppl. 1991; 20:1–97.
22. Padmavathi R, Rajkuma S, Srinivasan TN. Schizophrenic patients who were never treated- a study in an Indian urban sommunity. Psychol Med. 1998: 28 (5): 1113-7.
23. Lane A, Byrne M, Mulvany F, Kinsella A, Waddington JL, Wash D, Larkin C, O’Callaghan E. Reproductive behavior in schizophrenia relative to other mental disorders; evidence for increased fertility in men despite reduced marital rate. Acta Psychiatr Scand. 1995; 91:222–8.
24. Zemishlany Z, Weizman A. The impact of mental illness on sexual dysfunction. In: Balon R (ed): sexual dysfunction the brain-body connection. Adv Psychosom Med 2008; 29: pp 89–106.
25. Hickling FW, McCallum M, Nooks L, Rodgers-Johnson P. Outcome of first contact schizophrenia in Jamaica. West Indian Med J. 2001; 50:194–7.
26. Mulkern VM, Maderscheid RW. Characteristics of community program clients in 1980 and 1984. Hosp Community Psychiatry. 1989; 40:165–72.
27. Kebede D, Alem A, Shibre T, Negash A, Fekadu A, Fekadu D, Deyassa N, Jacobsson L, Kullgren G. Onset and clinical course of schizophrenia in Butajira-Ethiopia—a community-based study. Soc Psychiatry Psychiatr Epidemiol. 2003; 38(11):625–31.
How to Cite
ISJANOVSKI, Viktor; NAUMOVSKA, Andromahi; BAJRAKTAROV, Stojan. LEVEL OF FUNCTIONING OF PATIENTS WITH SEVERE MENTAL ILLNESS BEFORE IMPLEMENTATION OF MULTIDISCIPLINARY COMMUNITY OF MENTAL HEALTH TEAMS IN SKOPJE , REPUBLIC OF NORTH MACEDONIA. Journal of Morphological Sciences, [S.l.], v. 6, n. 1, p. 31-37, may 2023. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/vol6no1-5>. Date accessed: 27 feb. 2024.