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Delay of diagnosis and treatment in psychiatric patients applying for a disability pension - a challenge for all of us

Apfel, T. and Riecher-Rössler, A.. (2008) Delay of diagnosis and treatment in psychiatric patients applying for a disability pension - a challenge for all of us. Swiss Medical Weekly, 138. pp. 348-354.

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Abstract

In an earlier study in 2002 we showed that of 101 persons applying for a disability pension for psychiatric reasons, a psychiatric diagnosis that affected their ability to work, could only be confirmed in 83%. Furthermore, and even more importantly, only 64% of these cases were receiving any psychiatric treatment and only 20% adequate drug therapy. Since this time there has been a great deal of discussion on the increasing numbers of people receiving a disability allowance in Switzerland.
QUESTIONS UNDER STUDY:
We evaluated whether, compared to the 2002 situation, application behaviour, expressed in more accurate diagnoses and treatment plans before filing the application for disability pension, has changed.
METHODS:
We examined 124 of 132 subjects who were assessed for the Swiss Invalidity Insurance at the psychiatric outpatient department of the University Hospital, Basel in 2004. Eight persons did not agree to participate in the study. The results were compared with the results of our earlier study.
RESULTS:
There were some significant differences between the 2002 and 2004 applicants. In 2004, there was a tendency to an even lower proportion of subjects with a psychiatric diagnosis affecting their ability to work (73% vs 83%, p <.1). Of these applicants, significantly more than in the previous study reported taking specific psychiatric medication (74% vs 50%, p <.01). However, the proportion of patients, who were sufficiently medicated as documented by adequate drug serum levels (37%) or who were receiving any form of psychotherapy in a broad sense (30%), was still fairly low. Furthermore, there was a lower proportion of affective disorders as the primary diagnosis (49% vs 62%, p <.1).
CONCLUSIONS:
The findings from our earlier study, namely, that psychiatric applicants for a disability pension were not sufficiently diagnosed and treated before the application, could largely be replicated. Only minor changes could be observed over the last couple of years, with psychotropic medications being taken by more applicants, which might partly be due to the ongoing discussion.
Faculties and Departments:03 Faculty of Medicine > Bereich Psychiatrie (Klinik) > Erwachsenenpsychiatrie UPK > Erwachsenenpsychiatrie (Riecher-Rössler)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Psychiatrie (Klinik) > Erwachsenenpsychiatrie UPK > Erwachsenenpsychiatrie (Riecher-Rössler)
UniBasel Contributors:Riecher-Rössler, Anita
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:EMH
ISSN:1424-7860
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:31 Dec 2015 10:48
Deposited On:08 Jun 2012 06:43

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