Psychiatric disorders in long-term sickness absence -- a population-based cross-sectional study.
OBJECTIVE
The study estimates the incidence of psychiatric disorders in long-term sickness absence (LSA; more than eight weeks of continuous sickness absence) over one year. The study is the first accounting for everybody on LSA by linking a psychiatric assessment for all persons on LSA to public registers.


METHODS
In a Danish population of 120,000 inhabitants all 2,414 incident persons on LSA within one year were posted a questionnaire, of whom 1,121 (46.4%) responded. In a two phase design the 1,121 sick-listed persons were screened for psychiatric disorders. Phase 2 consisted of 844 people with predefined scores on CMD-SQ of whom 423 were randomly invited to a psychiatric examination and 329 participated. A further 11 who did not fulfil the predefined criteria were invited, of whom eight participated. The examination included a diagnostic interview by Present State Examination.


RESULTS
The 329 examined persons in Phase 2 showed by binomial tests the following frequencies: any psychiatric disorder 57%, any depression 42%, and any anxiety 18%. In Phase 1, representative for everyone on LSA, the frequencies were 48% for any psychiatric disorder, 35% for any depression, 15% for any anxiety, and 7% for any somatoform disorder. Multivariable analyses showed that female sex and unemployment were predictors of a psychiatric disorder, whereas living with children below 18 years and being a skilled worker carried a reduced risk of a psychiatric disorder.


CONCLUSIONS
The high frequency of psychiatric disorders necessitates further population-based studies documenting the efficiency of screening and psychiatric examinations in LSA.
Søgaard
Hans Jørgen
HJ
Central Denmark Region, Regional Psychiatric Services, Herning and Psychiatric Research Unit West, Gl. Landevej 61, 7400 Herning, Denmark. hjsoegaard@dadlnet.dk
Bech
Per
P
D000328:Adult; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D018582:Sick Leave; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors