Skoglund Ingmarie, Björkelund Cecilia, Svenningsson Irene, Petersson Eva-Lisa, Augustsson Pia, Nejati Shabnam, Ariai Nashmil, Hange Dominique
Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
The Research and Development Department, Södra Älvsborg, Sven Eriksonsplatsen 4, 503 38 Borås, Sweden.
Heliyon. 2019 Jan 4;5(1):e01101. doi: 10.1016/j.heliyon.2018.e01101. eCollection 2019 Jan.
Compared to other European countries, Sweden's yearly sick leave expenditures are moderate. Common mental disorders (CMD) are important causes of sick leave, affecting 10-15% of the adult population. A Swedish register based study indicates that antidepressant therapy for patients on long-term sick leave for CMD leads to longer sick leave and higher frequency of non-time-limited sickness compensation as compared to psychotherapy, work oriented rehabilitation, and other therapies.
To verify if patients on antidepressant therapy and on long-term sick leave for depression, anxiety and stress-related mental disorders have a longer sick leave than patients treated with other therapies.
Prospective, observational study at 28 primary health care centers in the Region Västra Götaland, Sweden, including 192 patients on sick leave for CMD. Outcome measures were gross and net sick leave days.
There were no significant differences in sick leave days (gross or net) due to CMD when comparing the patients treated and not treated with antidepressants during the 12 month observation period. The groups differed at baseline only concerning frequency of exhaustion disorder, with a higher frequency of exhaustion disorder in the group without antidepressants. Analysis of other possible factors associated with shorter or longer sick leave only showed associations with the patient's own perception of possibility of returning to work in near and distant future. An important factor associated with longer sick leave was the patient's own perception of possibility of return to present workplace. As CMD are important causes of sick leave and sick leave costs, this factor should be highlighted in future research on the rehabilitation process.
与其他欧洲国家相比，瑞典每年的病假支出较为适度。常见精神障碍（CMD）是病假的重要原因，影响着10%至15%的成年人口。一项基于瑞典登记册的研究表明，与心理治疗、工作导向康复及其他疗法相比，为因CMD而长期病假的患者提供抗抑郁治疗会导致病假时间延长以及非限时疾病补偿频率更高。
验证因抑郁、焦虑和与压力相关的精神障碍而接受抗抑郁治疗且长期病假的患者是否比接受其他疗法的患者病假时间更长。
在瑞典西约塔兰地区的28个初级卫生保健中心进行前瞻性观察研究，纳入192名因CMD而病假的患者。结局指标为总病假天数和净病假天数。
在12个月的观察期内，比较接受和未接受抗抑郁药物治疗的患者，因CMD导致的病假天数（总病假天数或净病假天数）没有显著差异。两组在基线时仅在精疲力竭障碍频率方面存在差异，未使用抗抑郁药物的组精疲力竭障碍频率更高。对与病假时间长短相关的其他可能因素进行分析，结果仅显示与患者自身对近期和远期重返工作可能性的认知有关。与病假时间延长相关的一个重要因素是患者自身对回到当前工作场所可能性的认知。由于CMD是病假和病假成本的重要原因，这一因素应在未来关于康复过程的研究中得到突出强调。
