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Mental health
Prevalence, comorbidity, onset, severity and treatment of mental disorders among long-term sick-listed workers
  1. Bert Cornelius2,
  2. Jac van der Klink2,
  3. Sandra Brouwer2,
  4. Johan Groothoff1
  1. 1University of Groningen, Groningen, The Netherlands
  2. 2Research Center for Insurance Medicine, Amsterdam, The Netherlands

Abstract

Objectives To assess prevalence, comorbidity, onset, severity and treatment of mental disorders in a population of sick listed workers.

Methods In a cross-sectional design, data were collected from a sample of 346 long term sick listed Dutch workers in 2008-9. Respondents were interviewed using the Composite International Diagnostic Interview 3.0 (CIDI) generating lifetime, 12-month and 30-day DSM-IV mental disorder. Interview data were linked to administrative data on mental health and demographics.

Results Prevalence of any lifetime, 12-month and 30-day DSM-IV mental disorder is very high (mood disorder: 50.6%, 28.6%, 9.5%; anxiety disorder: 53.2%, 32.9%, 20.2%; substance use disorder 22.0%, 4.6%, 2.3%). All mental disorders have early ages of onset. Comorbidity of DSM-IV mental disorder is substantial (58.1% ≥1 lifetime; 33.7% ≥1 12-month; 15.8% has ≥1 30-day). Urogenital and gastrointestinal diseases, and neoplasms, coincide with 12-month mental disorder in 66.7%, 53.9% and 51.7% of cases. More than 2/3 of specific mental disorders are serious in terms of impairment and disability. Substantial numbers of respondents with 12-month DSM-IV mental disorder seek treatment with great delay or have no treatment at all (social phobia: 65.6%; major depression: 30.1%; general anxiety disorder: 25.0%).

Conclusions The results have implications for professionals in primary, occupational and insurance healthcare assessing disability due to poor mental health. Indications are found that mental disorders among long-term sick-listed workers are substantially underdiagnosed. More research is needed to identify determinants of undiagnosed and untreated mental disorders among long-term sick-listed workers.

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