Rate and spectrum of participation impairment in patients with chronic mental disorders: Comparison of self-and expert ratings

Mental disorders are regularly associated with disability and work absenteeism. Self- and observer appraisal can be distorted when it comes to socio-medical expert reports, e.g. on workability.

In 307 patients with mental illness or psychological problems at general practitioners offices, disability was assessed with the IMET self-rating (Instrument to Measure Impairment in Participation - self-rating) and IMEP physician rating IMET (Instrument to Measure Impairment in Participation - observer-rating), and capacity limitations with the Mini-ICF-APP (Short rating of activities and participation in psychological disorders according to the International Classification of Functioning, Disability and Health). The IMET impairment score is M = 4.09 (range ) and the IMEP score M = 3.57 (range ), reflecting "mild to moderate" impairment; with lowest scores for activities of daily living and highest scores for coping with work and stress. Patients and physician see the same spectrum of disabilities, but patients see themselves as more impaired. Participation restrictions were correlated with capacity limitations. Patients with mental disorders show relevant rates of participation impairment across different areas in life, and especially in relation to work. Patients and physicians have similar but also divergent views and should be seen as complementary.