COMO MEDIR LA INCAPACIDAD DE LOS TRASTORNOS MENTALES UTILIZANDO INSTRUMENTOS GENERICOS





COMO MEDIR LA INCAPACIDAD DE LOS TRASTORNOS MENTALES UTILIZANDO INSTRUMENTOS GENERICOS

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La utilización de medidas genéricas para la valoración de trastornos mentales nos brinda información importante complementaria a las medidas específicas de síntomas. Estas pueden ser una fuente de información útil para los análisis de política y economía en el sector de la salud. Por tal motivo, se deberían incorporar de forma más amplia en ensayos clínicos y evaluaciones de programas.
sanderson.jpg Autor:
Kristy Sanderson
Columnista Experto de SIIC
Artículos publicados por Kristy Sanderson
Recepción del artículo
8 de Septiembre, 2003
Primera edición
27 de Enero, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La incapacidad psiquiátrica ha sido considerada históricamente de manera separada en el campo más amplio de las incapacidades. El uso más extenso de medidas genéricas de incapacidad permitiría adoptar un enfoque integrado a las aplicaciones individuales, clínicas y políticas de la información sobre la incapacidad, y haría posible que los beneficios del tratamiento de la salud mental puedan ser comparados con otras intervenciones del cuidado de la salud. Este uso más extenso de las medidas genéricas sólo se vería apoyado si la incapacidad psiquiátrica fuera congruente con un modelo general de incapacidad. Este artículo explora: 1) la incapacidad como indicador importante de estado de salud no fatal; 2) el papel de los modelos genéricos de incapacidad para la medición; 3) la manera de aplicar la incapacidad genérica al campo de la salud mental, por medio de la sensibilidad a las diferencias en la incapacidad entre trastornos mentales diferentes. Los datos se obtuvieron del Australian National Survey of Mental Health and Wellbeing (Encuesta Nacional Australiana de Salud Mental y Bienestar), una encuesta domiciliaria de 10 641 adultos que valoraba participantes con 15 trastornos mentales diferentes y con trastornos por abuso de sustancias. Se encontró que la incapacidad genérica, según las mediciones de las herramientas SF-12, Breve Cuestionario de Incapacidad, y Días de Incapacidad, variaba según el tipo de trastorno. En modelos ajustados se asoció de manera importante con depresión, distimia, agorafobia, trastornos de ansiedad generalizada, dependencia de alcohol y drogas, trastornos de la personalidad y neurastenia. La incapacidad psiquiátrica puede ser valorada significativamente con medidas genéricas y esto debe ser recomendado.

Palabras clave
Incapacidad, medidas genéricas


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Abstract
Psychiatric disability has historically been considered separate to the broader disability field. A wider use of generic disability measures would allow an integrated approach to individual, clinical, and policy applications of disability information, and allow the benefits of mental health treatment to be compared with other health care interventions. This wider use of generic measures would only be supported if psychiatric disability was consistent with a general model of disability. This paper explores: 1) disability as an important indicator of non-fatal health status; 2) the role of generic models of disability in measurement; 3) the applicability of generic disability to the mental health field via sensitivity to differences in disability across different mental disorders. Data were drawn from the Australian National Survey of Mental Health and Wellbeing, a household survey of 10,641 adults that assessed participants for 15 mental and substance use disorders. Generic disability, as measured by the SF-12, Brief Disability Questionnaire, and Disability Days was found to vary by type of disorder, and in adjusted models was significantly associated with depression, dysthymia, agoraphobia, generalized anxiety disorder, alcohol and drug dependence, personality disorders, and neurasthenia. Psychiatric disability can be meaningfully assessed with generic measures and this should be encouraged.

Key words
Incapacidad, medidas genéricas


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Especialidades
Principal: Salud Mental
Relacionadas: Fisiatría, Medicina Interna



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Especialidad principal:
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