Severity of impaired functioning, disability and health among hospitalized patients with non-psychotic disorders

BACKGROUND: Mental disorders are currently a serious problem for society and require a systematic approach to prevention, treatment and rehabilitation. Among these disorders, 51.0% are non-psychotic. The application of the International Classification of Functioning (ICF) allows a fairly objective assessment of the severity of disorders that limit the life activity of patients and their dynamics, characterizing the effectiveness of treatment and rehabilitation. However, the use of the ICF in psychiatric practice is limited.

AIM: To evaluate the effectiveness of inpatient rehabilitation of patients with non-psychotic disorders based on the use of ICF.

MATERIALS AND METHODS: The object of the study was 317 psychiatric inpatients with non-psychotic disorders. The severity of life activity limitations according to the ICF at admission and discharge was studied. Inclusion criteria: age under 18; patient refusal to participate; acute psychotic symptomatology, gross cognitive defect. Statistical analysis was performed using application programs in Microsoft Office Excel 2010.

RESULTS: Women accounted for 59.9% (190 people) of those examined. In the age structure, people under 30 years of age accounted for 32.5% (103 people), 30–39 and 40–49 years — 21.8% and 20.2% (69 and 64 people, respectively), 50–59 years — 11.7% (37 people), 60 years and older — 13.8% (44 people). In the nosological structure, patients with neurotic, stress-related, and somatoform disorders accounted for 30.6% (97 people), mood disorders and personality and behavior disorders in adulthood — 25.3% (81 people) and 24.4% (74 people), respectively; with behavioral syndromes — 20.5% (65 people). The mean ICF scores at the beginning of treatment were: on impulse urges control — 1.52±0.19, emotion regulation — 1.59±0.18, motivation function — 1.40±0.21, appetite — 1.36±0.25, ability to overcome crisis situations — 1.90±0.19, coping with stress — 1,74±0.20, solving complex problems — 1.68±0.18, managing own activity — 1.59±0.16, regulating behavior during interaction — 1.07±0.22, maintaining child-parent relations — 1.12±0.18.

CONCLUSION: The use of ICF in psychiatric practice allows to determine the patient’s actual problems and their dynamics, which is necessary for the correction of therapy and assessment of its effectiveness.