title: Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics.
abstract: BACKGROUND
  Medically unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning. In this study we aimed to assess the longitudinal association between MUPS and work functioning over 2 years and the influence of job characteristics and depressive and anxiety disorders on this association.
  
  
  METHODS
  We assessed the longitudinal association between MUPS and work functioning, operationalized in terms of absenteeism and disability at work, in 1887 working participants from the Netherlands Study of Depression and Anxiety (NESDA). The NESDA study population included participants with a current depressive and/or anxiety disorder, participants with a lifetime risk and/or subthreshold symptoms and healthy controls. Absenteeism was assessed with the Health and Labour Questionnaire Short Form and disability with the World Health Organization Disability Assessment Schedule II. MUPS were measured with the Four Dimensional Symptom Questionnaire. Measurements were taken at baseline and at 2 years follow-up. We used mixed model analyses to correct for the dependency of observations within participants.
  
  
  RESULTS
  MUPS were positively associated with disability (regression coefficient 0.304; 95% CI 0.281-0.327) and with short and long-term absenteeism over 2 years (OR 1.030, 95% CI 1.016-1.045; OR 1.099, 95% CI 1.085-1.114). After adjusting for depressive disorders, anxiety disorders and job characteristics, associations weakened but remained significant.
  
  
  CONCLUSIONS
  Our results show that MUPS were positively associated with disability and absenteeism over 2 years, even after adjusting for depressive and anxiety disorders and job characteristics. This suggests that early identification of MUPS and adequate management is important.
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. m.denboeft@vumc.nl.
authors.forename: Madelon
authors.initials: M
authors.lastname: den Boeft
authors.affiliation: Department of Epidemiology & Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
authors.affiliation: Department of Epidemiology & Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Trynke
authors.initials: T
authors.lastname: Hoekstra
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Berend
authors.initials: B
authors.lastname: Terluin
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.|Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Mattijs E
authors.initials: ME
authors.lastname: Numans
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henriette E
authors.initials: HE
authors.lastname: van der Horst
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009784:Occupational Diseases / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D013001:Somatoform Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D000066477:Work Performance; D055815:Young Adult
keywords: Absenteeism; Disability; Medically unexplained physical symptoms; Psychiatric disorders; Work functioning