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. 2025 Dec;46(12):6181-6192.
doi: 10.1007/s10072-025-08487-y. Epub 2025 Oct 7.

The paradise-24 questionnaire: a review of language versions, psychometric evidence, and application in brain disorder

Luana Karoline Castro Silva  1 , Lidiane Andrea Oliveira Lima  2 , Carla Sabariego  3   4   5 , Luana Wendy de Oliveira Sousa  2 , Shamyr Sulyvan de Castro  6   2
Affiliations

The paradise-24 questionnaire: a review of language versions, psychometric evidence, and application in brain disorder

Luana Karoline Castro Silva et al. Neurol Sci. 2025 Dec.

Abstract

Background: The high prevalence of brain disorders and their impact on populations requires a better understanding of how affected individuals function daily. PARADISE-24, a tool based on the biopsychosocial model of the International Classification of Functioning, Disability, and Health (ICF), was designed to assess the impact of brain disorders. However, information on translations, psychometric properties, and its use remains limited.

Objective: This systematic review aims to provide an overview of PARADISE-24 translations, psychometric properties, and the brain disorders in which it has been applied as an assessment tool.

Methods: The PRISMA statement guidelines informed the reporting. A structured literature search was performed until January 2025 in PubMed, APA PsycINFO, Web of Science, and SCOPUS. Two reviewers independently retrieved studies. The studies' methodological quality and the quality of evidence were stated.

Results: From 919 identified studies, twelve articles were included. Five evaluated psychometric measures and seven used PARADISE-24 to identify impacts in individuals with multiple sclerosis, epilepsy, migraine, stroke, schizophrenia, Parkinson's disease, and people with substance use disorders. The results report high level of evidence in internal consistency, construct validity, and responsiveness, and considered moderate evidence available in reliability due to the doubtful methodological quality of the studies. Only one translated version was found.

Conclusion: Although the PARADISE-24 questionnaire is one of the first and only that assesses the impact of brain disorders based on the ICF, this questionnaire had only four measurement properties evaluated. More validation studies are needed, as well as encouragement for translating the PARADISE-24 into other languages.

Keywords: International Classification of Functioning, Disability and Health; Nervous System Diseases; Psychometrics; Psychosocial Functioning.

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Conflict of interest statement

Declarations. Ethical Statement: This article is a review of previously published literature. No new studies involving human participants or animals were conducted by the authors, and therefore ethical approval was not required. Conflicts of interest: The authors declared no conflicts of interest. Informed consent: This study is a systematic review based solely on secondary data obtained from previously published studies. No primary data was collected directly from human participants, and no individual identities were disclosed. Therefore, informed consent is not applicable.

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