Straight or fractured? The DIDCO lifeline framework: a structured multidimensional model for psychiatric work...

Psychiatric work capacity evaluation remains characterized by substantial inter-rater variability and limited transparency in medico-legal contexts. While several validated dimensions relevant to work capacity assessment already exist-including diagnostic severity, functional impairment, ecological functioning, and occupational demands-psychiatry still lacks an integrated and visually structured framework allowing coherent synthesis of these elements in routine expert practice. This article proposes the DIDCO Lifeline framework, a multidimensional graphical model designed to support psychiatric work capacity evaluation through structured integration of five domains: diagnostic severity, ICF-based functional impairment, daily-life functioning, clinical coherence and plausibility, and occupational demands. Based on long-term clinical and medico-legal practice, the framework combines a structured classification table with a continuous graphical "lifeline" representation. Within this model, coherent clinical presentations generate relatively continuous profiles, whereas marked discontinuities or "fractures" between domains may indicate inconsistencies requiring further clinical interpretation and reassessment. The framework is not intended to introduce a new psychometric construct, but rather to provide practical organizational and communication tool integrating already established clinical dimensions into a transparent and structured representation. The DIDCO Lifeline may facilitate communication between treating psychiatrists, experts, insurers, and legal authorities by making the underlying clinical reasoning more explicit and visually accessible. The model also provides practical support for structured expert assessment in complex psychiatric disability evaluations.