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

M. Balestrieri 1 , J. Lenzi 2 , A. Lestani 1 , F. Taboga 3 , R. Bonn 3 , P. Rucci 2 , E. Maso 1,3

1 Department of Experimental and Clinical Medical Sciences, University of Udine; 2 Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna; 3 North-Udine Community Mental Health Center, Udine Local Health Authority


To investigate the capacity and participation restrictions over one-year 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).


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.


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.

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