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

Abstract

BackgroundMedically 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.MethodsWe 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.ResultsMUPS 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.ConclusionOur 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.

Demographic and health-related factors associated with reduced work functioning in people with moderate medically unexplained physical symptoms: a cross-sectional study

“…Regarding the findings about an increased probability of somatization in the present study, it may be possible that an increased probability of somatization will lead to absenteeism and impaired work performance in people with moderate MUPS. This is supported by the results of Den Boeft et al who reported that moderate or high risk of somatization is associated with a higher absenteeism rate, even after adjusting for depressive and anxiety disorders and job characteristics [22]. Concerning the finding that an increased probability of an increased severity of distress was associated with a higher impaired work performance rate, it may be possible that an increased severity of distress will lead to a higher impaired work performance rate in people with moderate MUPS, since psychological distress led to an increased risk of impaired work performance for a range of other health conditions in previous research [47].…”

“…Additionally, a widely adopted rule of thumb to achieve an adequate power, is to have at least ten outcome events per independent variable, thus the sample size in this study may be inadequate [45]. However, since results of the present study coincided with research on reduced work functioning in other populations, results of the present study seem reliable [21][22][23]47]. The impaired work performance analysis met the assumptions for linear regression.…”

“…Absenteeism rates were computed by dividing the number of days absent from work due to health problems during the last four weeks by the number of workdays a person was supposed to work in the last four weeks. A higher rate indicates more absenteeism in the last 4 weeks [22,23].…”

“…Absenteeism is operationalized as the workdays a person was absent divided by the workdays a person was supposed to work in the last four weeks [22,23]. Impaired work performance due to presenteeism (productivity loss due to working while sick or experiencing MUPS) is operationalized as the amount of lost working hours per week due to health-related productivity loss [22,23]. Over 80% of the people with MUPS, with no or only partial absenteeism, reported impaired work performance [14].…”

Transtornos de ansiedade como causa de afastamentos laborais

“…Uma associação longitudinal entre sintomas físicos inexplicados e funcionamento do trabalho, realizada em um estudo com 1.887 participantes na Holanda, mostrou-se prevalente (52,8%) e pode afetar o funcionamento do trabalho. Isso foi associado à incapacidade e ao afastamento do trabalhador em curto e longo prazo, ao longo de 2 anos, por distúrbios depressivos e transtornos de ansiedade 27 .…”