Disability and psychiatric disorders.

Sir,

Epidemiologic research in community and clinical settings reveals a strong correlation between psychiatric disorders and impaired socio-occupational functioning. This is seen more frequently in primary care setting among patients with depressive and anxiety disorders. Depressive disorders have been associated with a large number of disability days and poorer role functioning than several common medical diseases like arthritis, hypertension, and diabetes. Longitudinal studies of primary care patients provide evidence for the disabling effects of mood and anxiety disorders. The link between specific mental disorders and functional disability may be confounded by the co-occurrence of multiple mental disorders within the same individual.[1] Ali investigated disability in schizophrenia and found that majority of patients were having moderate level of disability in personal, social, occupational, physical, and general areas. He also observed that age of onset of psychiatric illness and duration of illness had a significant effect on disability.[2] Whiteside studied child adaptation of the Sheehan Disability Scale and found it to be a valid measure for assessing disability in children.[3] Leon et al. examined social and occupational disability associated with several DSM-IV mental disorders in a group of adult primary care outpatients using the Sheehan Disability Scale and found that only patients with major depressive disorder, bipolar disorder, phobias, and substance use disorders had significantly increased disability. They concluded that individual psychiatric disorders have distinct patterns of psychiatric co-morbidity and disability.[4] Mohan et al. assessed the disability in patients with schizophrenia and obsessive compulsive disorder (OCD) using Indian Disability Evaluation Assessment Scale (IDEAS). They found that schizophrenia caused greater disability than OCD in patients. They concluded that these illnesses affect all areas of daily functioning leading to greater disability and pose significant challenges for the rehabilitation of patients and their inclusion in the mainstream of the family and society.[5] We believe that rehabilitation of psychiatric patients is extremely important for the long-term prognosis and care of the patient. Hence, further community-based research studies in the arena of psychiatric rehabilitation are necessary.