The first cooperation between the CIMH and WHO started in 1978 with the WHO Collaborative Study "On the Assessment and Reduction of Psychiatric Disability", a multicentre study on the course and social consequences of schizophrenic psychoses.
Since then the CIMH has been active in WHO projects, e.g. the Clinic for Children and Adolescents participated in the translation and evaluation of the latest version of the International Classification of Mental and Behavioral Disorders (ICD10, Chapt. F7 - F9). Then the CIMH organised and participated in a multicentre reliability study of the ICD10 Chapt. F2 (psychotic disorders).
Since August 1991 the CIMH has coordinated a SCAN Training Centre for the German speaking countries. SCAN (Schedules for Clinical Assessment in Neuropsychiatry), a comprehensive clinical interview, suitable for standardised ICD10 diagnoses, was designed for the assessment of psychopathological symptoms of mental disorders in adult life. It was developed by WHO with the assistance of more than 20 collaborating centres, a.o. the Mannheim-based CIMH. The main tasks of SCAN centres are the translation of SCAN documents (instruments, glossaries, training materials etc.), research on SCAN (e.g. reliability exercises), organisation of SCAN training courses, and advising the users of SCAN and other WHO research instruments.
Besides this, the Mannheim WHO Collaborting Centre is currently consulting the psychiatric reform projects in Campinas (Brasil) and Luxemburg. Furthermore, it is cooperating in two WHO multicentre studies, the "International Study of Schizophrenia (ISoS)" and the "WHO Quality of Life"-Study (WHOQOL). SCAN Training Centre
The SCAN Centre was funded by the Federal Ministry of Health until 1994 and thereafter by the Research Funds of the University of Heidelberg from 1995 until 1997 to conduct the following tasks:
Translation of the SCAN: The SCAN Version 1.0 based on a version that was prepared for the SCAN Field Trial, in which we participated. SCAN 1.0 was published in 1995, and the translation of and research on SCAN 2.0 was completed in 1996. SCAN is often said to be too time consuming especially in clinical use. This is why the SCAN Short Version was developed by WHO. The translation of the short version was completed in 1997. The adaptation of the SCAN to the DSM-IV made another revision necessary (SCAN 2.1). Now a German translation of SCAN 2.1 is underway.
Development of ICD10 algorithms: A diagnostic algorithm was developed in four steps: 1. attachment of SCAN items to the diagnostic ICD10 criteria for research. This step produced a set of checklists, which can also be used to derive "manual" diagnoses. 2. Transformation of these attachment rules into SPSS statements, which corresponds to the programming task. 3. Programme testing by fictious and real data. 4. Solution of further problems, such as the treatment of missing data or automatic change of item values when the cut off rule is applied. The programme development is planned to be completed by the end of 1998 after a phase of programme testing.
SCAN Training Courses: One of the main tasks of a SCAN centre is to provide training courses. At the Mannheim centre the courses are usually scheduled for a whole week, but shorter, three-day courses too, are organised. Since 1992, 33 SCAN courses took place, and 271 participants have been educated in the use of the SCAN. Cooperation in WHO multicentre studies
Data of the Determinants of Outcome Study, a 12-centres 10-countries schizophrenia study, were made available for the Schizophrenia Research Unit (Head: Prof. Häfner). Meanwhile, some of the analyses have been completed and published. The SCAN Project analysed multicentre data of the WHO Disability Study in the context of the modification of the "International Classification of Impairments, Disabilities, and Handicaps". In the WHO International Study of Schizophrenia (ISoS) 20 research centres in 15 countries are collaborating to study the long term course of schizophrenia. Participating in this WHO study is also the project on "Course, Therapy and Relapse in Schizophrenia 14 Years after the Onset of the Disorder", under the supervision of Dr. an der Heiden and funded by the German Ministry of Research and Technology/Education, Science, Research and Technology (BMFT/BMBF) over 4 years.
Another study, conducted by Dr. Kühner and Prof. Henn and funded by the Research Funds of the University of Heidelberg, has been commenced as part of the WHO Quality of Life project (WHOQOL). The main objective is to investigate the post-discharge course of the illness and quality of life in a cohort of patients with depression. The course of depressive disorders from hospital admission until 16 months after discharge is assessed for psychopathology, psychological functioning and quality of life. At the 16-months assessment, the depressive group is compared with a sample of healthy controls from the Mannheim population, matched for age and sex and examined with the same instruments as the depressive sample. Consultation and cooperation at WHO meetings and in WHO programmes
The CIMH continues to consult the City of Campinas in Brasil and the Great Dukedom of Luxemburg. The Ministry of Health of Luxemburg has appointed Prof. Häfner President of the Scientific Advisory Board for the Mathëllëf foundation, which was created to assist the reform process of the psychiatric care system.
A "Consensus Meeting on Psychogeriatrics" was held in Lausanne (Switzerland) with Prof. Häfner in the chair. The meeting was organised by the ?WHO Section of Geriatric Psychiatry? together with the ?International Psychiatric Association (IPA)? and the "Geriatric Psychiatry Section of the World Psychiatric Association (WPA)".
WPA is launching a world wide programme against the stigma of schizophrenia, supported by WHO. Prof. Häfner has been appointed Chairman of the Review Committee. In this function he is also member of the Steering Committee of the "WPA global programme against stigma & discrimination because of schizophrenia". |
