Explanatory model of disability in a population with severe mental disorders: A multicenter study in three countries of south america

Abstract

Introduction: Currently, evidence is being generated on the use of the International Classification of Functioning, Disability, and Health-derived tools in psychiatry and mental health. This study corresponds to the first investigation of explanatory character about a wide range of persons with severe mental disorders in three countries of South America. Aim: This study aims to determine an explanatory model of disability in a population with severe mental disorders in contact with outpatient psychiatry services in Chile, Colombia, and Ecuador. Materials and methods: A multicenter, observational, correlational, cross-sectional study was carried out based on a probabilistic sampling in Colombia and a convenience sampling in Chile and Ecuador. A total of 803 adults with severe mental disorders participated, who were in contact with outpatient psychiatry services in Concepción (Chile), Cali (Colombia), and Quito (Ecuador). Results: Some degree of disability was presented by 91.3% of participants. The final multivariate model included the explanatory variables country (Colombia; β = 6.724); age (β = −0.163); schooling (β = −0.5029); current depression symptoms (β = 23.26), psychotic episode (β = 4.795); hypomanic/manic episode (β = 7,498; t = 3,711); to have religious practice (β = −2.834); and to have a caregiver (β = 10.363); a coefficient of determination of 0.3275 (F [23, 760] = 16.09; p < 0.001M R2∆ = 30.71) was obtained, explaining a 32.75% disability in participants from the three participating countries. Conclusions: Current symptoms and the presence of a caregiver are the main explanatory variables of the disability burden in a multivariate model of disability for severe mental disorders.