The application of the International Classification of Functioning, Disability, and Health in psychiatry: possible reasons for the lack of implementation.

The purpose of this article was to examine the application of the International Classification of Functioning, Disability, and Health (ICF) in the field of psychiatry in the last 10 yrs since the ICF was launched. The hypothesis is that the application of the ICF in the field of psychiatry has not been yet much explored. Therefore, the objective of this article was to provide reasons to explain the difficult implementation of the ICF in this field, which in turn, might account for the lack of studies. A literature search was conducted using the terms ICF AND mental illness OR mental disorders OR psychiatry in titles, abstracts, and key words of articles collected in the databases ISI Web of Knowledge, ScienceDirect and Medline from 2001 to 2010. A total of 64 full-length articles were retrieved and reviewed, and among them, 13 were eventually included in this review because they were related to the ICF in psychiatry. Of the 13 studies identified concerning the ICF and mental disorders, 7 focus on the implementation of the ICF in the clinical practice, and 6 are theoretical papers discussing the potential benefits of the ICF for the field of psychiatry. A number of reasons can be suggested to explain the paucity of studies on the use of the ICF in psychiatry in the last 10 yrs: (1) the novelty of the ICF and the dominance of the medical model, (2) the belief that disability is just about physical conditions, (3) the influence of medication on capacity and performance, (4) the complex structure of the ICF, (5) the intrinsic limitations of the ICF, and (6) limitations in the accessibility of the ICF to some medical professionals.