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.
Highlights
Unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning
The longitudinal association between Medically unexplained physical symptoms (MUPS) and disability at work We found a strong positive association between MUPS and disability at work on average over time (Table 2)
Depressive disorders had the greatest influence on the association between MUPS and disability as the regression coefficient became smaller, followed by anxiety disorders
Summary
Unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning. It was shown that the prevalence of severe MUPS was higher in the long-term absent employees compared to the non-sick working population [7]. These findings are supported by international studies [12, 13] and the relevance of the problem is reinforced by a 10-year follow-up study by Rask et al, who concluded that severe MUPS have significant impact on work functioning, and mild and recent onset MUPS [5]. Despite the relevance of absenteeism and disability from work caused by MUPS, limited research has been performed to assess potential influencing factors on the relationship between MUPS and work functioning and their association over time [14]
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