[Occupational rehabilitation of patients with mental or psychosomatic disorders. Study of 389 cases].

The study of all the patients sent to the PPU by the disablement insurance in 1975 and 1976 (389 cases). The comparison of the propositions made in medical reports and the actual allowances provided by the disablement insurance reveals the following data: in 326 cases (84%) out of 389, medical doctors only conclude to the presence or absence of a certain rate of disability (from 0 to 100%), to the exclusion of any rehabilitational measure. In 63 cases (16%) measures were proposed such as a professional rehabilitation or a placing in a specialized institution for insertion to a new profession. For this second group, only in 27 cases was the disablement insurance able to follow the medical propositions. Only in 3 cases the measures taken can be considered fully successful, and in 1 case partially successful. All the other measures taken failed. A first examination of the group of 326 cases (propositions only for disablement) which concerned 297 cases also shows a certain number of discordances between the medical propositions and the allowances provided by the disablement insurance. The majority of the discordances has to do with an undervaluation of the rate of disablement by the medical experts. Moreover, the examination of the diagnosis shows that readaptation measures are more easily proposed to patients with psychosomatic complaints, to young men, and allowances rather to women and to patients with obvious psychiatric disorders. The authors discuss some assumptions regarding these observations.