title: The impact of psychiatric comorbidity on the return to work in patients undergoing herniated disc surgery.
abstract: BACKGROUND
  This study examines (1) return to work (RTW) and ability to work (ATW) rates, and the association with (2) psychiatric comorbidity and (3) socio-demographic, illness-related, vocational and rehabilitation-related characteristics in herniated disc surgery patients.
  
  
  METHODS
  In this longitudinal observational study 305 consecutive patients took part in face-to-face interviews during hospital stay. 277 patients also participated in a 3-month follow-up survey via telephone (drop-out rate 9%). Psychiatric comorbidity was assessed with the Composite International Diagnostic Interview (CIDI-DIA-X). Calculations were conducted via Chi-Square tests, independent T-tests and binary logistic regression analyses.
  
  
  RESULTS
  40.1% of the herniated disc patients in this study were able to RTW, 44.4% had regained their ATW 3 months after surgery. Psychiatric comorbidity appeared to be an important risk factor for RTW and ATW. Other risk factors were lower educational qualification, unemployment status, a lower subjective prognosis of gainful employment, a higher number of herniated discs in medical history, cervical disc surgery, and the existence of other chronic diseases, a longer hospital stay and higher pain intensity. Patients who did not RTW, or did not regain their ATW participated more often in inpatient rehabilitation.
  
  
  CONCLUSIONS
  Identifying a high risk group for RTW and ATW at an early age is of utmost importance for the purpose of improving rehabilitation effects and to make a return to the work place easier. Specific interventions, such as social-medical counselling, pain therapy and management, as well as the assistance of mental health professionals during hospital and rehabilitation treatment are recommended for this risk group.
authors.affiliation: Department of Social Medicine, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. Margrit.Zieger@medizin.uni-leipzig.de
authors.forename: Margrit
authors.initials: M
authors.lastname: Zieger
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Hans Jörg
authors.initials: HJ
authors.lastname: Meisel
authors.forename: Lutz
authors.initials: L
authors.lastname: Günther
authors.forename: Dirk
authors.initials: D
authors.lastname: Winkler
authors.forename: René
authors.initials: R
authors.lastname: Toussaint
authors.forename: Katarina
authors.initials: K
authors.lastname: Stengler
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D020127:Recovery of Function; D012050:Rehabilitation, Vocational / Q000379:methods*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014938:Work Capacity Evaluation; D055815:Young Adult