Type, distribution, and frequency of psychological capacity disorders in patients with different somatic illnesses.

Abstract

Somatic illnesses are often accompanied by (psychological) capacity impairments which impact on everyday life and work. The question is whether different somatic illnesses are associated with different capacity impairments, and whether impairment is more severe in cases of comorbid mental disorders. Patients with neurological (<i>N</i> = 318), cardiological (<i>N</i> = 307) and orthopedic illness (<i>N</i> = 311) with and without comorbid mental illness according to MINI were investigated in a rehabilitation hospital. Psychological capacity impairments were assessed with the Mini-ICF-APP observer rating. The "baseline rate" of capacity impairment in patients without mental illnesses was 40.7% in orthopedic, in 36% of cardiology patients (36.1%) and in 74.9% of neurology patients. Patients with additional comorbid mental disorders had stronger impairments than those without mental illness. The most heavily impaired group overall were neurology patients with comorbid mental illness. Somatic patients also have psychological impairments; these are more pronounced in the case of comorbid mental illnesses. It should be clearly explored whether psychological symptoms and impairment are an expression of the somatic illness per se, or due to a comorbid mental illness. Rehabilitation diagnostics should consider capacity impairments routinely in order to make indications for capacity trainings or context adjustment.