Does multidisciplinary assessment of long-term sickness absentees result in modification of sick-listing diagnoses?
OBJECTIVE
The aim was to study whether sick-leave diagnoses of long-term sickness absentees were modified after a multidisciplinary assessment and if modifications differed with type of medical specialty of the latest physician to sick-list the patient.


METHODS
A sample of 635 long-term sickness absentees referred to a multidisciplinary assessment by Social Insurance Offices was included. Data were obtained through sickness certificates and medical records. Patients were examined by board-certified specialists in psychiatry, orthopaedic surgery, and rehabilitation medicine. Descriptive statistics were used.


RESULTS
The multidisciplinary assessment resulted in an increase from 1-2 to 2-3 diagnoses for most patients. Forty-five per cent of the male and 47% of the female patients had only somatic diagnoses at referral. After the multidisciplinary assessment these percentages were 20% and 29%, respectively. The rate of women and men given both psychiatric and somatic diagnoses increased from 30% at referral to about 55%. The shift from either only psychiatric or only somatic diagnoses to having these diagnoses in combination was associated with type of specialty of the physician who had sick-listed the patient.


CONCLUSIONS
The study indicates that many patients on long-term sick-leave with unclear diagnoses may suffer from unrecognized, and therefore probably untreated, medical disorders and co-morbidity.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. pia.svedberg@ki.se
Pia
P
Svedberg
Peter
P
Salmi
Jan
J
Hagberg
Göran
G
Lundh
Jürgen
J
Linder
Kristina
K
Alexanderson
D000041:Absenteeism; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D012017:Referral and Consultation; D018582:Sick Leave; D013548:Sweden; D014938:Work Capacity Evaluation