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Gen Hosp Psychiatry. 2015 Jan-Feb;37(1):53-9. doi: 10.1016/j.genhosppsych.2014.10.007. Epub 2014 Oct 22.

Sick leave and work disability in primary care patients with recent-onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study.

Author information

1
Research Unit for General Practice, Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark. Electronic address: mette.rask@feap.dk.
2
Research Unit for General Practice, Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark. Electronic address: m.rosendal@feap.dk.
3
Research Unit for General Practice, Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark. Electronic address: mfgr@feap.dk.
4
Research Unit for General Practice, Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark. Electronic address: fbro@feap.dk.
5
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Barthsgade 5, 8200 Aarhus N, Denmark. Electronic address: eva.oernboel@aarhus.rm.dk.
6
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Barthsgade 5, 8200 Aarhus N, Denmark. Electronic address: per.fink@aarhus.rm.dk.

Abstract

OBJECTIVE:

The objective was to explore patient characteristics and 10-year outcome of sick leave and work disability for patients with recent-onset multiple medically unexplained symptoms (MUS) and persistent somatoform disorders (SD).

METHOD:

Consecutive patients consulting their family physician (FP) completed a preconsultation questionnaire on symptoms and mental illness (n=1785). The main problem was categorized by the FP after the consultation, and a stratified subsample was examined using a standardized diagnostic interview (n=701). Patients were grouped into three cohorts: recent onset of multiple MUS (n=84); Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, persistent SD (n=183); and reference group with well-defined physical disease according to FP (n=833). Register data on sick leave and disability pension were obtained.

RESULTS:

At index consultation, disability pension was received by 8.3% (n=7) in the recent-onset multiple MUS group, 19.1% (n=35) in the SD group and 3.5% (n=29) in the reference group. Both the recent-onset multiple MUS group [hazard ratio (HR)=2.28, 95% confidence interval (CI): 1.14-4.55] and the SD group (HR=3.26, 95% CI:1.93-5.51) had increased risk of new disability pension awards. Furthermore, the SD group had increased risk of sick leave.

CONCLUSIONS:

Both recent-onset and persistent MUS have significant long-term impact on patient functioning in regard to working life; this calls for early recognition and adequate management of MUS in primary care.

KEYWORDS:

Classification; Medically unexplained symptoms; Primary health care; Sick leave; Somatoform disorders

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