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BMC Primary Care
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics

Authors: Madelon den Boeft, Jos W. R. Twisk, Trynke Hoekstra, Berend Terluin, Brenda W. J. H. Penninx, Johannes C. van der Wouden, Mattijs E. Numans, Henriette E. van der Horst

Published in: BMC Primary Care | Issue 1/2016

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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.

Conclusion

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.
Literature
1.
Burton C. Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS). Br J Gen Pract. 2003;53:231–9.PubMedPubMedCentral
2.
Kroenke K, Spitzer RL, Williams JBW. The PHQ-15: validity of a New measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002;64:258–66.CrossRefPubMed
3.
Fink P, Rosendal M, Olesen F. Classification of somatization and functional somatic symptoms in primary care. Aust N Z J Psychiatry. 2005;39:772–81.CrossRefPubMed
4.
5.
Rask MT, Rosendal M, Fenger-Grøn M, Bro F, Ornbol E, Fink P. 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. Gen Hosp Psychiatry. 2015;37:53–9.CrossRefPubMed
6.
Hoedeman R, Blankenstein AH, Krol B, Koopmans PC, Groothoff JW. The contribution of high levels of somatic symptom severity to sickness absence duration, disability and discharge. J Occup Rehabil. 2010;20:264–73.CrossRefPubMedPubMedCentral
7.
Hoedeman R, Krol B, Blankenstein N, Krol B, Koopmans PC, Groothoff JW. Severe MUPS in a sick-listed population: a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment. BMC Public Health. 2009;9:440.CrossRefPubMedPubMedCentral
8.
Konnopka A, Kaufmann C, König H-H, Heider D, Wild B, Szecseyni J, et al. Association of costs with somatic symptom severity in patients with medically unexplained symptoms. J Psychosom Res. 2013;75:370–5.CrossRefPubMed
9.
Konnopka A, Schaefert R, Heinrich S, Kaufmann C, Luppa M, Herzog W, et al. Economics of medically unexplained symptoms: a systematic review of the literature. Psychother Psychosom. 2012;81:265–75.CrossRefPubMed
10.
Roelen CAM, van der Pol TR, Koopmans PC, Groothoff JW. Identifying workers at risk of sickness absence by questionnaire. Occup Med Oxf Engl. 2006;56:442–6.CrossRef
11.
Terluin B, van Rhenen W, Anema JR, Taris TW. Psychological symptoms and subsequent sickness absence. Int Arch Occup Environ Health. 2011;84:825–37.CrossRefPubMed
12.
Norrmén G, Svärdsudd K, Andersson DKG. How primary health care physicians make sick listing decisions: the impact of medical factors and functioning. BMC Fam Pract. 2008;9:3.CrossRefPubMedPubMedCentral
13.
Hansen A, Edlund C, Bränholm I-B. Significant resources needed for return to work after sick leave. Work Read Mass. 2005;25:231–40.
14.
Aamland A, Malterud K, Werner EL. Phenomena associated with sick leave among primary care patients with medically unexplained physical symptoms: a systematic review. Scand J Prim Health Care. 2012;30:147–55.CrossRefPubMedPubMedCentral
15.
Christensen KB, Labriola M, Lund T, Kivimäki M. Explaining the social gradient in long-term sickness absence: a prospective study of Danish employees. J Epidemiol Community Health. 2008;62:181–3.CrossRefPubMed
16.
North FM, Syme SL, Feeney A, Shipley M, Marmot M. Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health. 1996;86:332–40.CrossRefPubMedPubMedCentral
17.
Roelen CAM, Schreuder KJ, Koopmans PC, Groothoff JW. Perceived job demands relate to self-reported health complaints. Occup Med Oxf Engl. 2008;58:58–63.CrossRef
18.
Melchior M, Niedhammer I, Berkman LF, Goldberg M. Do psychosocial work factors and social relations exert independent effects on sickness absence? A six year prospective study of the GAZEL cohort. J Epidemiol Community Health. 2003;57:285–93.CrossRefPubMedPubMedCentral
19.
Sparks K, Cooper C, Fried Y, Shirom A. The effects of hours of work on health: a meta-analytic review. J Occup Organ Psychol. 1997;70:391–408.CrossRef
20.
van Boven K, Lucassen P, van Ravesteijn H, Olde Hartman T, Bor H, van Weel-Baumgarten E, et al. Do unexplained symptoms predict anxiety or depression? Ten-year data from a practice-based research network. Br J Gen Pract J R Coll Gen Pract. 2011;61:316–25.CrossRef
21.
Penninx BWJH, Beekman ATF, Smit JH, Zitman FG, Nolen WA, Spinhoven P, et al. The Netherlands study of depression and anxiety (NESDA): rationale, objectives and methods. Int J Methods Psychiatr Res. 2008;17:121–40.CrossRefPubMed
22.
Chwastiak LA, Von Korff M. Disability in depression and back pain: evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. J Clin Epidemiol. 2003;56:507–514.CrossRefPubMed
23.
Bouwmans C, Jong KD, Timman R, Zijlstra-Vlasveld M, van der Feltz-Cornelis C, Tan SS, et al. Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P). BMC Health Serv Res. 2013;13:217.CrossRefPubMedPubMedCentral
24.
Plaisier I, Beekman ATF, de Graaf R, Smit JH, van Dyck R, Penninx BWJH. Work functioning in persons with depressive and anxiety disorders: the role of specific psychopathological characteristics. J Affect Disord. 2010;125:198–206.CrossRefPubMed
25.
Terluin B, van Marwijk HW, Adèr HJ, de Vet HCW, Penninx BWJH, Hermens MLM, et al. The four-dimensional symptom questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization. BMC Psychiatry. 2006;6:34.CrossRefPubMedPubMedCentral
26.
Plaisier I, de Graaf R, de Bruijn J, Smit J, van Dyck R, Beekman A, et al. Depressive and anxiety disorders on-the-job: the importance of job characteristics for good work functioning in persons with depressive and anxiety disorders. Psychiatry Res. 2012;200:382–8.CrossRefPubMed
27.
Karasek R, Theorell T. Healthy work, stress, productivity, and the reconstruction of working life. New York: Basic Books; 1990.
28.
Aamland A, Malterud K, Werner EL. Patients with persistent medically unexplained physical symptoms: a descriptive study from Norwegian general practice. BMC Fam Pract. 2014;15:107.CrossRefPubMedPubMedCentral
29.
30.
Twisk JWR. Applied longitudinal data analysis for epidemiology. 2nd ed. Cambridge: Cambridge University Press; 2013.CrossRef
31.
Loengaard K, Bjorner JB, Fink PK, Burr H, Rugulies R. Medically unexplained symptoms and the risk of loss of labor market participation - a prospective study in the Danish population. BMC Public Health. 2015;15:844.CrossRefPubMedPubMedCentral
32.
Aamland A, Werner EL, Malterud K. Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients’ experiences. Scand J Prim Health Care. 2013;31:95–100.CrossRefPubMedPubMedCentral
Metadata
Title
Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics
Authors
Madelon den Boeft
Jos W. R. Twisk
Trynke Hoekstra
Berend Terluin
Brenda W. J. H. Penninx
Johannes C. van der Wouden
Mattijs E. Numans
Henriette E. van der Horst
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0443-x

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