title: Do mental disorders matter? A study of absenteeism among care seeking Gulf War veterans with ill defined conditions and musculoskeletal disorders.
abstract: OBJECTIVE
  To investigate the extent that common psychological conditions contribute to lost work among individuals with musculoskeletal and ill defined conditions.
  
  
  METHODS
  Cross sectional health and work related survey evaluating Gulf War veterans seeking Department of Defense health care for Gulf War related health concerns. Ordered probit models were used to study whether a provider diagnosed musculoskeletal condition (ICD-9 codes 710-739) or "signs, symptoms, and ill defined conditions" (ICD-9 codes 780-799) have an effect on recent lost work over the previous 90 days in the presence of one or more psychological conditions (ICD-9 codes 290-320) after controlling for sociodemographic variables.
  
  
  RESULTS
  Bivariate analyses revealed that musculoskeletal conditions, ill defined conditions, and psychological conditions were positively associated with lost work. Multivariate analyses showed an independent effect of both psychological conditions and musculoskeletal conditions. A significant interaction existed between psychological conditions and musculoskeletal conditions: the presence of a coexisting psychological condition considerably increased the likelihood that a musculoskeletal disorder resulted in lost work, or vice versa.
  
  
  CONCLUSIONS
  Psychological conditions appear to be an important contributor to absenteeism among individuals with musculoskeletal and ill defined conditions. A limitation of the cross sectional design was the inability to sequence the onset of conditions.
authors.affiliation: United States Air Force, San Antonio, Texas 78253, USA. tdremsa@satx.rr.com
authors.forename: T L
authors.initials: TL
authors.lastname: Dremsa
authors.forename: C C
authors.initials: CC
authors.lastname: Engel
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.forename: M
authors.initials: M
authors.lastname: Johantgen
authors.forename: S
authors.initials: S
authors.lastname: Smith
mesh_terms: D000041:Absenteeism; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D009140:Musculoskeletal Diseases / Q000523:psychology* / Q000628:therapy; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D018923:Persian Gulf Syndrome / Q000523:psychology*; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data