Aim: To analyze the relationship between duration of prior certified sick leave and the course of symptom severity in a prospective study.
Methods: The severity of psychiatric symptoms was assessed in 109 patients of a psychosomatic/psychotherapeutic polyclinic. Using a basic patient documentation and the Symptom-Check-List SCL-90-R, sociodemographic information, diagnosis, symptom duration, and duration of sick leave were assessed at admission and four to six months later. Intra-individual difference scores were calculated for each patient to assess changes in the severity of psychiatric symptoms.
Results: A highly significant interaction between the course of symptom severity, duration of prior sick leave, and diagnostic group was found with two-factorial analysis of variance (F=2.888; P>/=0.01). At the second assessment, patients with anxiety disorders and longer sick leave showed a higher degree of deterioration in symptoms compared with anxiety patients with shorter or no prior sick leave. The patients with depression disorders and long certified sick leave achieved a higher degree of improvement in symptoms compared with depressive patients with shorter or no prior certified sick leave.
Conclusion: Different diagnostic groups of psychiatric patients require different strategies for certifying sick leave.