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Do mental disorders matter? A study of absenteeism among care seeking Gulf War veterans with ill defined conditions and musculoskeletal disorders
  1. T L Dremsa1,
  2. C C Engel, Jr2,
  3. X Liu2,
  4. M Johantgen3,
  5. S Smith2
  1. 1United States Air Force, San Antonio, Texas, USA
  2. 2US Army
  3. 3University of Maryland, Baltimore, MD, USA
  1. Correspondence to:
 Lt Col T L Dremsa, USAF, NC, 12242 Netherwood Ln, San Antonio, TX 78253, USA;


Aims: To investigate the extent that common psychological conditions contribute to lost work among individuals with musculoskeletal and ill defined conditions.

Methods: Cross sectional health and work related survey evaluating Gulf War veterans seeking Department of Defense health care for Gulf War related health concerns. Ordered probit models were used to study whether a provider diagnosed musculoskeletal condition (ICD-9 codes 710–739) or “signs, symptoms, and ill defined conditions” (ICD-9 codes 780–799) have an effect on recent lost work over the previous 90 days in the presence of one or more psychological conditions (ICD-9 codes 290–320) after controlling for sociodemographic variables.

Results: Bivariate analyses revealed that musculoskeletal conditions, ill defined conditions, and psychological conditions were positively associated with lost work. Multivariate analyses showed an independent effect of both psychological conditions and musculoskeletal conditions. A significant interaction existed between psychological conditions and musculoskeletal conditions: the presence of a coexisting psychological condition considerably increased the likelihood that a musculoskeletal disorder resulted in lost work, or vice versa.

Conclusions: Psychological conditions appear to be an important contributor to absenteeism among individuals with musculoskeletal and ill defined conditions. A limitation of the cross sectional design was the inability to sequence the onset of conditions.

  • musculoskeletal condition
  • psychological condition
  • ordered probit analyses
  • ill defined condition
  • absenteeism

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  • The views expressed by the authors in this article are their own and do not reflect the official policy or position of the Uniformed Services University, Walter Reed Army Medical Center, Department of the Army, the Department of Defense, the United States Air Force, or the US Government.