Disorders of Functioning in Neurotic Disorders

Abstract

Background:

The International Classification of Functioning, Disability and Health, ICF, discriminates between functions, activities/capacities, context factors and participation. There is only limited information on disorders of capacity in neurotic disorders.

Method:

213 inpatients of a department of behavioral and psychosomatic medicine (70% women, median age 45 years) were rated with the “Mini-ICF-Rating for Pychological Disorders, Mini-ICF-P”. This instrument assesses thirteen dimensions of capacity, derived fom the ICF, which can be impaired by mental disorders. Rating varies between 0 (no problem) to 4 (can not fullfill respective requirements at all).

61% of patients suffered from disorders from section F4 (neurotic, adjustment and somatoform disorders) of the ICD-10 (WHO, 1991), 29% from F3 (affective disorders) and 10% from F6 (personality disorders).

Results:

41% were on sick leave before admission. The average global score of the Mini-ICF-P was 0,84 (SD = 0,56), corresponding to “mild disability”. Highest disability was found for “flexibility” (M = 1,64, SD = 0,94), and lowest for “self maintenance” (M = 0,19, SD = 0,44) and “mobility” (M = 0,43, SD = 0,85). The Mini-ICF-P-score and profile was correlated with rate and duration of sick leave, but also type of disorder (e.g. depression vs. phobias), and course of treatment.

Conclusion:

Comparatively minor disorders of capacity are associated with high rates of sick leave, i.e. disorders of participation. Not only restoration of functons but also of capacities should be targets of treatment.