Severe medically unexplained physical symptoms in the sick-listed occupational health population

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In the introduction, in Chapter 1, the results of the different studies showed that medically unexplained physical symptoms (MUPS) are quite common in sick-listed employees, but in the working population there is a lower prevalence of MUPS. Various studies have focused on the associations between fatigue and sickness absence and reported on the prevalence of MUPS in employees with lasting disabilities. The prevalence of MUPS in general samples ofsick-listed employees has not yet been investigated. Therefore, in contrast to primary care, it is not known which impact MUPS have on healthrelated functioning and the duration ofsickness absence, or their associations with psychiatric co-morbidity, and the consultation load of occupational health physicians (OHPs). Furthermore, we do not know whether OHPs experience difficulties in the consultations, what these difficulties are, what diagnoses they make, their needs for adjustment with general practitioners (OPs) and for the involvement of a psychologist or a psychiatrist. The main goal of this thesis was to answer these research questions in a representative sample of sick-listed employees in the Netherlands. Chapters 2, 3, and 4 describe the results of our cross-sectional study, and Chapter 5 presents the results of a 2-year follow-up on the outcomes of duration of sickness absence, health-related discharge and lasting disabilities. ...

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