title: 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.
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).
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: Mette T
authors.initials: MT
authors.lastname: Rask
authors.affiliation: 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.
authors.forename: Marianne
authors.initials: M
authors.lastname: Rosendal
authors.affiliation: 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.
authors.forename: Morten
authors.initials: M
authors.lastname: Fenger-Grøn
authors.affiliation: 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.
authors.forename: Flemming
authors.initials: F
authors.lastname: Bro
authors.affiliation: Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Barthsgade 5, 8200 Aarhus N, Denmark. Electronic address: eva.oernboel@aarhus.rm.dk.
authors.forename: Eva
authors.initials: E
authors.lastname: Ørnbøl
authors.affiliation: Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Barthsgade 5, 8200 Aarhus N, Denmark. Electronic address: per.fink@aarhus.rm.dk.
authors.forename: Per
authors.initials: P
authors.lastname: Fink
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018868:Insurance, Disability / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D018582:Sick Leave / Q000706:statistics & numerical data*; D013001:Somatoform Disorders / Q000191:economics / Q000453:epidemiology*; D013997:Time Factors; D014938:Work Capacity Evaluation
keywords: Classification; Medically unexplained symptoms; Primary health care; Sick leave; Somatoform disorders