[Do psychiatric patients receive disability pension before adequate diagnostics and treatment? Evaluation of 101 psychiatric expertises done on behalf of Swiss Invalidity Insurance and the Psychiatric Outpatient Department Basel in 2002].
OBJECTIVE
a) Does the psychiatric expertise confirm the claimed psychiatric diagnoses in patients applying for a disability pension due to a psychiatric (co)morbidity? b) Had the patients received adequate psychiatric treatment before being sent for the psychiatric disability expertise?


METHODS
Key data of 101 psychiatric expertises done in 2002 on behalf of the Swiss invalidity insurance/Basel were analysed.


RESULTS
a) 17% did not have a psychiatric diagnosis affecting the ability to work. In 50%, the ability to work was reduced by max. 30%, i. e. the prerequisites of a pension were not met. b) Patients with a psychiatric diagnosis affecting the ability to work: 50% reported to take a specific psychotropic medication, but only in 40% of them (i. e. 20% of the patients with a psychiatric disorder) the blood level was within the therapeutic range; only 35 % reported to have "some form of psychotherapy"; only 15% had been previously hospitalized.


CONCLUSIONS
Many of the 101 patients applying for a disability pension had not been sufficiently diagnosed and had not received adequate psychiatric/psychotherapeutic treatment before the expertise.
Apfel
Tabea
T
Psychiatrische Poliklinik Universitätsspital Basel, Schweiz. tapfel@uhbs.ch
Riecher-Rössler
Anita
A
D000328:Adult; D000368:Aged; D015897:Comorbidity; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D008875:Middle Aged; D019989:Persons with Intellectual Disabilities / Q000331:legislation & jurisprudence* / Q000534:rehabilitation; D012943:Social Security / Q000331:legislation & jurisprudence*; D013557:Switzerland; D014938:Work Capacity Evaluation