Mental health and functioning: a case analysis of rehabilitation patients.

The relationship between mental health and functioning has been inconsistently described. Here, the role of mental health in determining functioning was studied from a large multi-axial (biopsychosocial) and multi-dimensional (impairments, disabilities and handicaps) point of view. Case-analysis of rehabilitation patients indicated that inconsistent findings may be due to an incorrect linearity assumption. Results indicated that: (1) good mental health may aid the patient to benefit from rehabilitation. However, (2) it does not guarantee good future functioning, because the impact of mental health on functioning varies in interaction with other functional aspects. On the other hand, (3) poor mental health does not necessarily impede good future functioning, whereas (4) poor mental health, associated with other aspects of poor functioning, quite reliably predicts poor functioning after rehabilitation. It was concluded that single psychological factors cannot predict functioning. To improve prediction, broader models of functional assessment in rehabilitation should be used.

Psychologists' role in functional assessment of rehabilitation patients.

In this study attention was paid to the psychological criteria that clinicians may use when assessing global functioning of rehabilitation patients. Global functioning was understood to be determined by physical, psychological and social factors and was operationally defined as performance in three different areas of life: work, daily activities and human relations. The psychological factors whose relationships to global functioning were studied were three components of personality dynamics:--mental health, cognitive skills and motivation. Patients' mental health, cognitive abilities, motivation and global functioning were clinically rated on the basis of data given by psychological interview, psychological test-results and other information. Correlation analysis showed that the clinicians tend to use the mental health state, the level of cognitive performance and the degree of motivation as criteria when assessing the functioning of rehabilitation patients during the rehabilitation examination. However, multiple regression analysis showed that these psychological variables explained as little as 32% of the variance in follow-up functioning. This is in agreement with the biopsychosocial view that psychological factors are only one class of events manifesting in illness, functioning and behavior.