title: High prevalence of early onset mental disorders among long-term disability claimants.
abstract: OBJECTIVE
  To provide information on prevalence, comorbidity, age-of-onset and severity of mental disorders among persons claiming disability after long-term sickness absence.
  
  
  METHODS
  Cross-sectional analysis of a cohort of Dutch disability claimants (n = 346). Composite International Diagnostic Interview (CIDI) 3.0 was used to generate DSM-IV classifications of mental disorder, age-of-onset and severity; registry data were used on demographics and ICD-10 classifications of somatic disorder.
  
  
  RESULTS
  The mean age of respondents was 49.8 (range 22-64). The most prevalent broad categories of mental disorders were mood and anxiety disorder with a 12-month prevalence of 28.6% and 32.9%, respectively. Mood and most anxiety disorders had ages of onset in adolescence and early adulthood. The phobias start at school age. Of all respondents, 33.7% had ≥1 12-month mental disorder. Co-occurrence of substance use disorders, phobias and depression/anxiety disorders is frequent. Urogenital and gastrointestinal diseases, and cancer coincide with 12-month mental disorder in 66.7%, 53.9% and 51.7% of cases, respectively. More than two out of three specific mental disorders are serious in terms of disability and days out of working role.
  
  
  CONCLUSIONS
  Disability claimants constitute a vulnerable population with a high prevalence of serious mental disorder, substantial comorbidity and ages-of-onset in early working careers. More research is needed to help prevent long-term sickness absence and disability of claimants with mental health problems.
  
  
  CONCLUSIONS
  This study shows common mental disorders, such as mood and anxiety disorders, to be highly prevalent among persons claiming disability benefit after long-term sickness absence, to have early onsets and to often co-occur with somatic disorders. Professionals in primary and occupational health care should assess need for treatment of workers at risk, while at the same time being careful not to medicalize normal life problems. Insurance physicians assessing disability benefit claims should identify factors that caused claimants to call in sick and start interventions to promote return to work.
authors.affiliation: a Department of Health Sciences, Community and Occupational Medicine , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands .|b Research Center for Insurance Medicine , Amsterdam , The Netherlands .|c Social Security Institute , Amsterdam , The Netherlands , and.
authors.forename: L R
authors.initials: LR
authors.lastname: Cornelius
authors.affiliation: a Department of Health Sciences, Community and Occupational Medicine , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands .|b Research Center for Insurance Medicine , Amsterdam , The Netherlands .
authors.forename: J J L
authors.initials: JJ
authors.lastname: van der Klink
authors.affiliation: d Department of Health Sciences , VU University , Amsterdam , The Netherlands.
authors.forename: M R
authors.initials: MR
authors.lastname: de Boer
authors.affiliation: a Department of Health Sciences, Community and Occupational Medicine , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands .|b Research Center for Insurance Medicine , Amsterdam , The Netherlands .
authors.forename: S
authors.initials: S
authors.lastname: Brouwer
authors.affiliation: a Department of Health Sciences, Community and Occupational Medicine , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands .
authors.forename: J W
authors.initials: JW
authors.lastname: Groothoff
mesh_terms: D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D052801:Male Urogenital Diseases / Q000453:epidemiology; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D009369:Neoplasms / Q000453:epidemiology; D009426:Netherlands; D010698:Phobic Disorders / Q000453:epidemiology; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult
keywords: Age-of-onset; DSM-IV; comorbidity; disability claimants; mental disorder; prevalence; severity