Objectives To determine UK trends (from 1996 to 2009) in incidence of work-related mental ill-health and musculoskeletal disorders, for all industry as well as for health and social care employees. Second, to investigate whether there may have been a recent shift from a physical to psychological perspective in how patients present their illness by comparing reporting trends for back pain and ‘other work stress’.

Methods Multilevel models were used to investigate changes in incidence of work-related illness, as diagnosed by specialist physicians. The dependent variable comprised case reports to The Health and Occupation Research network. Comparisons were made between medical specialties, industry (health and social care vs all other employees), gender and diagnosis.

Results Trends for Occupational Physicians’ (OP) reporting mental ill-health (average annual increase +3.7% (95% CI +2.2% to +5.2%)) differed significantly (p<0.001) from psychiatrists’ reporting over the same time period (−5.9% (95% CI −7.6% to −4.2%)). For OPs’ reporting, the rate of increase was greater for females and for health and social care employees. A fall in incidence of musculoskeletal disorders for OPs of −5.8% (95% CI −7.3% to −4.3%) and rheumatologists’ reporting −6.6% (95% CI −8.3% to −4.8%) was found, with little variation by gender or industry. Within health and social care, an increase in incidence of ‘other work stress’ was accompanied by a similar decrease in ‘spine/back pain’.

Conclusions The evidence presented is consistent with a shift in the presentation of ill-health from a physical to psychological perspective, although changes in hazards, prevention measures and physician awareness should also be considered as explanations.