gms | German Medical Science

61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

Psychiatric comorbidity on the return to work in patients undergoing herniated disc surgery

Meeting Abstract

  • Bodo-Christian Kern - Department of Neurosurgery, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Germany
  • Hans Jörg Meisel - Department of Neurosurgery, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Germany
  • Margrit Zieger - Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig, Germany
  • Melanie Luppa - Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig, Germany
  • Lutz Günther - Department of Neurosurgery, Klinikum St. Georg gGmbH, Leipzig, Germany
  • Jürgen Meixensberger - Department of Neurosurgery, University of Leipzig, Germany
  • Steffi G. Riedel-Heller - Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig,; Department of Social Medicine, University of Leipzig, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1684

DOI: 10.3205/10dgnc155, URN: urn:nbn:de:0183-10dgnc1555

Veröffentlicht: 16. September 2010

© 2010 Kern et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Even though previous back surgery is assumed to be a potential risk factor for return to work (RTW) in back pain patients only few studies actually investigated predictive factors for RTW in patients undergoing herniated disc surgery. This study are (1) to examine RTW and ability to work (ATW) rates in patients undergoing herniated disc surgery three months after surgical treatment, to examine whether psychiatric comorbidity is associated with a higher risk for non-return to work (NRTW) and non-ability to work (NATW) respectively in patients undergoing disc surgery, and to investigate which socio-demographic, illness-related, vocational and rehabilitation-related characteristics are associated with RTW and ATW.

Methods: The sample consists of 305 patients aged between 18 and 55 years and taking part in face-to-face interviews during hospital stay. 277 of these patients also participated in a 3-month Follow-up survey via telephone. Psychiatric comorbidity was assessed with the Composite International Diagnostic Interview (CIDI-DIA-X). Socio-demographic, illness-related, vocational and rehabilitation-related variables were examined upon their association with RTW and ATW. Calculations were conducted via Chi-Square-tests, independent t-tests and binary logistic regression analyses.

Results: 40.1% of the herniated disc patients in this study were able to RTW three months after surgical treatment, 44.4% had regained their ATW in this period of time. Psychiatric comorbidity turned out to be an important risk factor for RTW and ATW. Other risk factors seem to be a lower educational qualification, unemployment status, a lower subjective prognosis of gainful employment, a higher number of herniated discs in medical history, cervical disc surgery, and the existence of other chronic diseases, a longer hospital stay and higher pain intensity. Patients who did not RTW, nor regained their ATW participated more often in inpatient rehabilitation.

Conclusions: Identifying a high risk group for RTW and ATW at an early age is of utmost importance for the purpose of improving rehabilitation effects and to make a return to work place easier. The assessment of psychological comorbidity, pain and the subjective prognosis of gainful employment during hospital and rehabilitation treatment should be considered. Specific interventions, such as social-medical counselling, pain therapy and management, as well as the assistance by mental health professionals during hospital.