Primary Health Care/School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Research, Education, Development & innovation, Primary Health care, Region Västra Götaland, Vänersborg, Sweden.
BMJ Open. 2022 Jul 8;12(7):e054250. doi: 10.1136/bmjopen-2021-054250.
The aim was to determine symptom patterns of depression, anxiety and stress-related mental disorders in newly sick listed due to common mental disorders in Swedish primary care patients and to examine associations with sick leave diagnosis, also in relation to socioeconomic, work-related and demographic factors.
Cross-sectional study.
Primary care in western Sweden.
From a randomised controlled trial, patients aged 18-67, seeking primary care and on sick leave due to depression, anxiety and/or mental stress, in total 341 individuals, during 2018-2020.
Patterns of depressive, anxiety and stress symptoms measured via self-assessment questionnaires (Montgomery Asberg Depression Rating Scale-Self MADRS-S), General Anxiety Disorder Scale-7 (GAD-7), Karolinska Exhaustion Disorder Scale (KEDS)), sick leave diagnosis, perception of Work Ability Index and job strain via the job strain model.
A combination of high levels of depressive and stress-related symptoms was more frequent than single symptom clusters among persons with common mental disorders (CMD) on sick leave: 7% of the patients had scores above cut-off for one of the instruments MADRS-S, GAD-7 and KEDS, 12% above cut-off for two and 80% had above cut-off for all three instruments. There was no significant association between low socioeconomic status, high-job strain or working in healthcare/education and having scores above cut-off level for two or more of the instruments. Only perception of own poor work ability showed association with having scores above cut-off level for all three of the assessment instruments of CMD (OR 9.45, 95% CI 2.41 to 37.04).
The diagnosis on the sick certificate is not always congruent with the dominating symptom score level. In patients sick-leaved for CMDs, possible negative factors such as low socioeconomic status, low social support, high-work strain or working in healthcare/education sector did not show significant associations with self-assessment instruments of anxiety, depression and stress. Only patient's perception of own poor work ability was associated with high scores on all three domains.
NCT03250026.
旨在确定新发病例中因常见精神障碍而被列入 sick list 的患者的抑郁、焦虑和与压力相关的精神障碍的症状模式，并研究其与病假诊断的关联，以及与社会经济、与工作相关和人口统计学因素的关联。
横断面研究。
瑞典西部的初级保健。
来自一项随机对照试验，年龄在 18-67 岁之间，因抑郁、焦虑和/或精神压力而在 2018-2020 年期间寻求初级保健并请病假的患者，共 341 人。
使用自我评估问卷（蒙哥马利抑郁评定量表-自我 MADRS-S）、广泛性焦虑症量表-7（GAD-7）、卡罗林斯卡疲劳症量表（KEDS）测量抑郁、焦虑和压力症状模式，病假诊断，通过工作压力模型感知工作能力指数和工作压力。
与请病假的患有常见精神障碍（CMD）的患者中单一症状群相比，具有较高水平的抑郁和与压力相关的症状的组合更为常见：MADRS-S、GAD-7 和 KEDS 三种量表中，有 7%的患者得分超过临界值，有 12%的患者得分超过两种量表的临界值，有 80%的患者得分超过三种量表的临界值。社会经济地位低、工作压力高或从事医疗保健/教育工作与两种或更多种量表得分超过临界值之间没有显著关联。只有对自身工作能力的感知与三种 CMD 评估工具的得分超过临界值有关（比值比 9.45，95%置信区间 2.41 至 37.04）。
病假证明上的诊断并不总是与主导症状得分水平一致。在因 CMD 而请病假的患者中，可能的负面因素，如社会经济地位低、社会支持低、工作压力高或从事医疗保健/教育行业，与焦虑、抑郁和压力的自我评估工具没有显著关联。只有患者对自身工作能力的感知与所有三个领域的高分有关。
NCT03250026。
