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Long-term sick-leavers with difficulty in resuming work: comparisons between psychiatric-somatic co-morbidity and monodiagnosis
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
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2009 (English)In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 32, no 1, p. 20-35Article in journal (Refereed) Published
Abstract [en]

The number of patients with difficulty in resuming work after long-term sick leave has increased in several European countries including Sweden. The general aim of this study was a comprehensive description - based on multidisciplinary diagnostics and assessments - of patients with the common feature of marked difficulty in resuming working life after a long absence. A particular aim was to elucidate the possible effect of comorbidity on pain descriptors, disability, quality of life, assessed working ability and rehabilitation needs. Six hundred and thirty-five long-term sick leavers were referred from National Insurance Offices and consecutively accepted for investigation. Several self-report questionnaires were used. All patients were examined by three board-certified specialist physicians in psychiatry, orthopaedic surgery and rehabilitation medicine, respectively. Fifty-five percent of the patients had psychiatric-somatic comorbidity. The three most frequent combinations of diagnoses in the comorbidity group were fibromyalgia/myalgia and depressive episode, fibromyalgia/myalgia and recurrent depression, spinal pain and depressive episode, whereas the three most frequent in those with psychiatric diagnosis only were depressive episode, recurrent depression, phobias/anxiety. Differences in pain descriptors and in difficulties with activities were found among the three groups. All had lower health-related quality of life than references. Only one-sixth had no assessed working capacity and only 3% were assessed as able to resume work without rehabilitation; 80% were multidisciplinarily assessed as needing rehabilitation. Patients with psychiatric diagnoses, with or without concomitant somatic diagnoses, need medical rehabilitation or medical/vocational rehabilitation in combination to a greater extent than patients with somatic diagnoses only. This implies that medical rehabilitation programmes ought to adapt increasingly to the needs of patients with psychiatric-somatic comorbidity.

Place, publisher, year, edition, pages
2009. Vol. 32, no 1, p. 20-35
Keywords [sv]
rehabiliteringsvetenskap
National Category
Public Health, Global Health, Social Medicine and Epidemiology
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URN: urn:nbn:se:miun:diva-6595DOI: 10.1097/MRR.0b013e328306351dISI: 000264360000003Scopus ID: 2-s2.0-67650928599Local ID: 5681OAI: oai:DiVA.org:miun-6595DiVA, id: diva2:31634
Available from: 2009-02-24 Created: 2009-02-24 Last updated: 2017-12-12Bibliographically approved

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Schüldt Ekholm, Kristina

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