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. 2002 Aug;59(8):532–536. doi: 10.1136/oem.59.8.532

Do mental disorders matter? A study of absenteeism among care seeking Gulf War veterans with ill defined conditions and musculoskeletal disorders

T Dremsa 1, C Engel 1, X Liu 1, M Johantgen 1, S Smith 1
PMCID: PMC1740339  PMID: 12151609

Abstract

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.

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Selected References

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  1. Armenian H. K., Pratt L. A., Gallo J., Eaton W. W. Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland. Am J Epidemiol. 1998 Aug 1;148(3):269–275. doi: 10.1093/oxfordjournals.aje.a009635. [DOI] [PubMed] [Google Scholar]
  2. Crook J., Moldofsky H., Shannon H. Determinants of disability after a work related musculetal injury. J Rheumatol. 1998 Aug;25(8):1570–1577. [PubMed] [Google Scholar]
  3. Engel C. C., Jr, Ursano R., Magruder C., Tartaglione R., Jing Z., Labbate L. A., Debakey S. Psychological conditions diagnosed among veterans seeking Department of Defense Care for Gulf War-related health concerns. J Occup Environ Med. 1999 May;41(5):384–392. doi: 10.1097/00043764-199905000-00006. [DOI] [PubMed] [Google Scholar]
  4. Fordyce W. E. On the nature of illness and disability: an editorial. Clin Orthop Relat Res. 1997 Mar;(336):47–51. doi: 10.1097/00003086-199703000-00007. [DOI] [PubMed] [Google Scholar]
  5. Jacobson B. H., Aldana S. G., Goetzel R. Z., Vardell K. D., Adams T. B., Pietras R. J. The relationship between perceived stress and self-reported illness-related absenteeism. Am J Health Promot. 1996 Sep-Oct;11(1):54–61. doi: 10.4278/0890-1171-11.1.54. [DOI] [PubMed] [Google Scholar]
  6. Joseph S. C. A comprehensive clinical evaluation of 20,000 Persian Gulf War veterans. Comprehensive Clinical Evaluation Program Evaluation Team. Mil Med. 1997 Mar;162(3):149–155. [PubMed] [Google Scholar]
  7. Katz J. N., Punnett L., Simmons B. P., Fossel A. H., Mooney N., Keller R. B. Workers' compensation recipients with carpal tunnel syndrome: the validity of self-reported health measures. Am J Public Health. 1996 Jan;86(1):52–56. doi: 10.2105/ajph.86.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kessler R. C., DuPont R. L., Berglund P., Wittchen H. U. Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. Am J Psychiatry. 1999 Dec;156(12):1915–1923. doi: 10.1176/ajp.156.12.1915. [DOI] [PubMed] [Google Scholar]
  9. Kessler R. C., Frank R. G. The impact of psychiatric disorders on work loss days. Psychol Med. 1997 Jul;27(4):861–873. doi: 10.1017/s0033291797004807. [DOI] [PubMed] [Google Scholar]
  10. Kouzis A. C., Eaton W. W. Psychopathology and the initiation of disability payments. Psychiatr Serv. 2000 Jul;51(7):908–913. doi: 10.1176/appi.ps.51.7.908. [DOI] [PubMed] [Google Scholar]
  11. Loeser J. D., Sullivan M. Doctors, diagnosis, and disability: a disastrous diversion. Clin Orthop Relat Res. 1997 Mar;(336):61–66. doi: 10.1097/00003086-199703000-00009. [DOI] [PubMed] [Google Scholar]
  12. Mintz J., Mintz L. I., Arruda M. J., Hwang S. S. Treatments of depression and the functional capacity to work. Arch Gen Psychiatry. 1992 Oct;49(10):761–768. doi: 10.1001/archpsyc.1992.01820100005001. [DOI] [PubMed] [Google Scholar]
  13. Ormel J., Vonkorff M., Oldehinkel A. J., Simon G., Tiemens B. G., Ustün T. B. Onset of disability in depressed and non-depressed primary care patients. Psychol Med. 1999 Jul;29(4):847–853. doi: 10.1017/s0033291799008600. [DOI] [PubMed] [Google Scholar]
  14. Revicki D. A., Irwin D., Reblando J., Simon G. E. The accuracy of self-reported disability days. Med Care. 1994 Apr;32(4):401–404. doi: 10.1097/00005650-199404000-00008. [DOI] [PubMed] [Google Scholar]
  15. Shah J. P., Gerber L. H. Evaluation of musculoskeletal disability: current concepts and practice. Am J Phys Med Rehabil. 1997 Jul-Aug;76(4):344–347. doi: 10.1097/00002060-199707000-00020. [DOI] [PubMed] [Google Scholar]
  16. Sherbourne C. D., Wells K. B., Meredith L. S., Jackson C. A., Camp P. Comorbid anxiety disorder and the functioning and well-being of chronically ill patients of general medical providers. Arch Gen Psychiatry. 1996 Oct;53(10):889–895. doi: 10.1001/archpsyc.1996.01830100035005. [DOI] [PubMed] [Google Scholar]
  17. Souêtre E., Lozet H., Cimarosti I. Predicting factors for absenteeism in patients with major depressive disorders. Eur J Epidemiol. 1997 Jan;13(1):87–93. doi: 10.1023/a:1007397913193. [DOI] [PubMed] [Google Scholar]
  18. Wells K. B., Sherbourne C. D. Functioning and utility for current health of patients with depression or chronic medical conditions in managed, primary care practices. Arch Gen Psychiatry. 1999 Oct;56(10):897–904. doi: 10.1001/archpsyc.56.10.897. [DOI] [PubMed] [Google Scholar]

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