Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study

ObjectivesTo investigate the correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Secondary aims were to investigate length of sick leave by diagnoses on sick leave certificates, diagnoses made in structured interviews and symptom severity.DesignObservational study consisting of a secondary analysis of data from a randomised controlled trial and an observational study.SettingThe regions of Stockholm and Västra Götaland, Sweden.Participants480 people on sick leave for common mental disorders.InterventionsParticipants were examined with structured psychiatric interviews and self-rated symptom severity scales.Outcome measures(1) Sick leave certificate diagnoses, (2) diagnoses from the Mini International Neuropsychiatric Interview and the Self-rated Stress-Induced Exhaustion Disorder (SED) Instrument (s-ED), (3) symptom severity (Montgomery-Asberg Depression Rating Scale-self-rating version and the Karolinska Exhaustion Disorder Scale) and (4) number of sick leave days.ResultsThere was little correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Many participants on sick leave for SED, anxiety disorder or depression fulfilled criteria for other mental disorders. Most on sick leave for SED (76%) and anxiety disorder (67%) had depression (p=0.041). Length of sick leave did not differ by certificate diagnoses. Participants with SED (s-ED) had longer sick leave than participants without SED (144 vs 84 days; 1.72 (1.37–2.16); p