One-year changes in capacity and participation in patients with schizophrenia or bipolar i disorder treated in community-based mental health services in Italy

Objective: To investigate the capacity and participation restrictions over oneyear in patients treated in community mental health services. Materials and Methods: We recruited 100 consecutive patients with schizophrenia or bipolar I disorder. The assessment instruments included the Mini-ICF-APP, the BPRS and the Clinical Global Impression Scale (CGI). Results: Capacity/participation restrictions and psychopathology levels improved significantly at one year in each diagnostic group. Moreover, changes in Mini-ICF-APP factors (proficiency, relational capacity, autonomy) were significantly higher in patients who were improved or much improved (CGI-Improvement = 1, 2) compared with those observed in patients who were not improved. A higher baseline functional impairment and a higher decrease in psychopathology predicted a higher improvement in total Mini-ICF-APP. After controlling for the effect of these predictors, no difference between diagnostic groups was found. Conclusions: When a community-based treatment is effective in reducing symptom severity, a concurrent improvement is obtained in capacity and participation functioning. The Mini-ICF-APP was sensitive to change in psychopathology and therefore can be used in routine clinical assessments.