Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study
Objectives To investigate the correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Secondary aims were to investigate length of sick leave by diagnoses on sick leave certificates, diagnoses made in structured interviews and symptom seve...
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| Format: | Article |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e057745.full |
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| author | Cecilia Björkelund Dominique Hange Jeanette Westman Anna Nager Jonas Hällgren Ingmarie Skoglund Sandra af Winklerfelt Hammarberg Anna Finnes |
| author_facet | Cecilia Björkelund Dominique Hange Jeanette Westman Anna Nager Jonas Hällgren Ingmarie Skoglund Sandra af Winklerfelt Hammarberg Anna Finnes |
| author_sort | Cecilia Björkelund |
| collection | DOAJ |
| description | Objectives To investigate the correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Secondary aims were to investigate length of sick leave by diagnoses on sick leave certificates, diagnoses made in structured interviews and symptom severity.Design Observational study consisting of a secondary analysis of data from a randomised controlled trial and an observational study.Setting The regions of Stockholm and Västra Götaland, Sweden.Participants 480 people on sick leave for common mental disorders.Interventions Participants were examined with structured psychiatric interviews and self-rated symptom severity scales.Outcome measures (1) Sick leave certificate diagnoses, (2) diagnoses from the Mini International Neuropsychiatric Interview and the Self-rated Stress-Induced Exhaustion Disorder (SED) Instrument (s-ED), (3) symptom severity (Montgomery-Asberg Depression Rating Scale-self-rating version and the Karolinska Exhaustion Disorder Scale) and (4) number of sick leave days.Results There was little correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Many participants on sick leave for SED, anxiety disorder or depression fulfilled criteria for other mental disorders. Most on sick leave for SED (76%) and anxiety disorder (67%) had depression (p=0.041). Length of sick leave did not differ by certificate diagnoses. Participants with SED (s-ED) had longer sick leave than participants without SED (144 vs 84 days; 1.72 (1.37–2.16); p<0.001). More severe symptoms were associated with longer sick leave.Conclusion Diagnoses on sick leave certificates did not reflect the complex and overlapping nature of the diagnoses found in the structured psychiatric interviews. This finding is relevant to the interpretation of information from health data registers, including studies and guidelines based on these data. A result of clinical interest was that more severe symptoms predicted long-term sick leave better than actual diagnoses. |
| format | Article |
| id | doaj-art-71c0296e12de44989061f9dcd7c071b9 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-71c0296e12de44989061f9dcd7c071b92025-02-01T13:40:13ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057745Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational studyCecilia Björkelund0Dominique Hange1Jeanette Westman2Anna Nager3Jonas Hällgren4Ingmarie Skoglund5Sandra af Winklerfelt Hammarberg6Anna Finnes74 Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Göteborg, Sweden4 Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Göteborg, SwedenAcademic Primary Health Care Centre, Stockholm, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SwedenAcademic Primary Care Center, Region Stockholm, Stockholm, Sweden4 General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenObjectives To investigate the correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Secondary aims were to investigate length of sick leave by diagnoses on sick leave certificates, diagnoses made in structured interviews and symptom severity.Design Observational study consisting of a secondary analysis of data from a randomised controlled trial and an observational study.Setting The regions of Stockholm and Västra Götaland, Sweden.Participants 480 people on sick leave for common mental disorders.Interventions Participants were examined with structured psychiatric interviews and self-rated symptom severity scales.Outcome measures (1) Sick leave certificate diagnoses, (2) diagnoses from the Mini International Neuropsychiatric Interview and the Self-rated Stress-Induced Exhaustion Disorder (SED) Instrument (s-ED), (3) symptom severity (Montgomery-Asberg Depression Rating Scale-self-rating version and the Karolinska Exhaustion Disorder Scale) and (4) number of sick leave days.Results There was little correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Many participants on sick leave for SED, anxiety disorder or depression fulfilled criteria for other mental disorders. Most on sick leave for SED (76%) and anxiety disorder (67%) had depression (p=0.041). Length of sick leave did not differ by certificate diagnoses. Participants with SED (s-ED) had longer sick leave than participants without SED (144 vs 84 days; 1.72 (1.37–2.16); p<0.001). More severe symptoms were associated with longer sick leave.Conclusion Diagnoses on sick leave certificates did not reflect the complex and overlapping nature of the diagnoses found in the structured psychiatric interviews. This finding is relevant to the interpretation of information from health data registers, including studies and guidelines based on these data. A result of clinical interest was that more severe symptoms predicted long-term sick leave better than actual diagnoses.https://bmjopen.bmj.com/content/12/6/e057745.full |
| spellingShingle | Cecilia Björkelund Dominique Hange Jeanette Westman Anna Nager Jonas Hällgren Ingmarie Skoglund Sandra af Winklerfelt Hammarberg Anna Finnes Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study BMJ Open |
| title | Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study |
| title_full | Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study |
| title_fullStr | Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study |
| title_full_unstemmed | Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study |
| title_short | Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study |
| title_sort | outcomes of psychiatric interviews and self rated symptom scales in people on sick leave for common mental disorders an observational study |
| url | https://bmjopen.bmj.com/content/12/6/e057745.full |
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