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[Temporal disability caused by psychiatric pathology at a health center]
M Sans1, C Batalla, D Villagrasa
1Centro de salud Dr. Pujol y Capsada, El Prat de Llobregat, Barcelona.
Objective:
To find the incidence, duration, diagnosis and treatment of time off work for psychiatric reasons.
Design:
Retrospective, descriptive study.
Setting:
The Dr. Pujol i Capsada Health Centre in Baix Llobregat county, Barcelona.
Participants:
All the records of time off occurring between January 1992 and December 1996 were reviewed. Time off for psychiatric reasons, and its length, follow-up, relapses and treatment were analysed.
Measurements And Main Results:
71 patients had had time off on some occasion for psychiatric reasons (34% men, 66% women). The mean age was 38 (SD 10). The mean number of days off in the first period of time off (n = 71) was 155 days (SD = 302), in the second (n = 21) 209 (SD = 268), in the third (n = 8) 187 (SD = 327), and in the fourth (n = 3) 206 days (SD = 326). Total number of days off came to 16,894. 4% obtained invalidity status for psychiatric reasons. The most common initial reasons for the first period of time off were, by pathology: psychiatric (58%), osteo-muscular (17%), nervous system and sense organs (7%) and digestive system (6%). The psychiatric reasons for the first period off were: anxiety (48%), depression (38%), anxiety-depression (10%), schizoid disorders (3%) and personality disorders (1%). Half the patients were referred and almost all were supervised by the general practitioner. The most commonly used drugs were the benzodiazepines (75%) and serotonin re-uptake inhibitors (38%).
Conclusions:
Time off for psychiatric reasons tends to last a long time and to recur. 42% of these periods of time off was not initially classified as for psychiatric reasons. Half the patients are shared and supervised jointly with the psychiatrist: thus, the need for good coordination between the two areas.