Journal
GENERAL HOSPITAL PSYCHIATRY
Volume 37, Issue 1, Pages 53-59Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.genhosppsych.2014.10.007
Keywords
Medically unexplained symptoms; Somatoform disorders; Primary health care; Classification; Sick leave
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Funding
- Danish foundation TrygFonden [7549-07]
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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). Method: 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. (C) 2014 The Authors. Published by Elsevier Inc.
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