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Psychiatric disorders in long-term sickness absence — a population-based cross-sectional study

Central Denmark Region, Regional Psychiatric Services, Herning and Psychiatric Research Unit West, Gl. Landevej 61, 7400 Herning, Denmark, hjsoegaard{at}dadlnet.dk

Per Bech

Psychiatric Research Unit, Frederiksborg General Hospital, Dyrehavevej 48, DK-3400 Hillerød, Denmark

Aims: The study estimates the incidence of psychiatric disorders in long-term sickness absence (LSA; more than eight weeks of continuous sickness absence) over one year. The study is the first accounting for everybody on LSA by linking a psychiatric assessment for all persons on LSA to public registers. Methods: In a Danish population of 120,000 inhabitants all 2,414 incident persons on LSA within one year were posted a questionnaire, of whom 1,121 (46.4%) responded. In a two phase design the 1,121 sick-listed persons were screened for psychiatric disorders. Phase 2 consisted of 844 people with predefined scores on CMD-SQ of whom 423 were randomly invited to a psychiatric examination and 329 participated. A further 11 who did not fulfil the predefined criteria were invited, of whom eight participated. The examination included a diagnostic interview by Present State Examination. Results: The 329 examined persons in Phase 2 showed by binomial tests the following frequencies: any psychiatric disorder 57%, any depression 42%, and any anxiety 18%. In Phase 1, representative for everyone on LSA, the frequencies were 48% for any psychiatric disorder, 35% for any depression, 15% for any anxiety, and 7% for any somatoform disorder. Multivariable analyses showed that female sex and unemployment were predictors of a psychiatric disorder, whereas living with children below 18 years and being a skilled worker carried a reduced risk of a psychiatric disorder. Conclusions: The high frequency of psychiatric disorders necessitates further population-based studies documenting the efficiency of screening and psychiatric examinations in LSA.

Key Words: Demography • diagnosis • epidemiology • sickness absence • socio-demographic characteristics • unreported diagnosis

This version was published on September 1, 2009

Scandinavian Journal of Public Health, Vol. 37, No. 7, 682-689 (2009)
DOI: 10.1177/1403494809344357


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