Cognitive disabilities: measuring the social consequences of mental disorders.

The disabilities associated with psychiatric illnesses can be separated into six cognitive levels that can be identified by functions the patient is able to perform, by the types of assistance required to compensate for dysfunctions, and by the social dysfunction observed in home and work environments. These cognitive levels can be used to measure the severity of mental disorders; changes in these levels reflect temporal changes in severity that are consequent to treatment and/or natural history of the condition. These cognitive levels can also be used to assess need for hospitalization and/or community placement, readiness for discharge from hospital, and effectiveness of treatment. A collaborative relationship between occupational therapists and psychiatrists is needed for the most effective use of these reliable and objective assessments of cognitive function levels in patients with psychiatric illness.