[Cumulative incidence, comorbility and disability for anxiety disorders in patients of a mutual worker accident]

Abstract

Objective: Neurotic disorders are one of the main health problems of Western societies. Its impact on labor productivity grows exponentially with an increase in its incidence and the duration of temporary disability (TD) processes. To know the characteristics of the patients belonging to a mutual of work accidents who had transient disability due to neurotic disorders, their temporal and geographic distribution, their comorbidities and those variables that affected their duration.

Methods: Retrospective descriptive study of the workers protected from a mutual of work accidents, national scope, who studied a disability period between 2006-2016 with diagnoses included between codes 300 and 300.9 of the CIE-9-CM, corresponding to Neurotic Disorders. We analyze clinical-demographic variables of patients, comorbidities during studied period and distributions by year and province, by Bayesian inference. We performed a logistic regression for the dependent variable duration of the TD adjusted for age, sex, toxic consumption, consultations, year, regulatory base and payment type.

Results: We registered 56,619 processes in Spain, which corresponded to 1.5% of the total TD processes served in the period. The highest percentage of cases was grouped between 2007 and 2009, when 11% of the population were registered annually. The variables associated with an increase in this duration were: older age, male sex, psychiatric and psychological consultations, diagnostic year, regulatory base (whose average was 50.5 euros) and type of payment (delegate in 78.2% of cases and direct in 21.8%). The prevalence by provinces was more marked in the north and the islands (Barcelona, Lleida, Las Palmas, Islas Baleares, Coruña, Cantabria, Girona, Álava, Tarragona, Pontevedra y Asturias they have more than 6%).The durations of the disability were greater in the east of the country. The most prevalent comorbidities during the study period were low back pain (with an average of 65.1 days of IT anxiety), cervical pain (with an average of 67 days) and digestive disorders (with an average of 59.4 days).

Conclusions: There are comorbidities and variables associated with the temporary disability derived from neurotic disorders, with geographical differences. Deepening their knowledge and impact could promote better preventive and therapeutic approaches that allow an earlier functional recovery.

Keywords: Anxiety disorders; Comorbidity; Epidemiology; Mental disorders; Sick leave; Spain.

Figura 1.. Incidencia acumulada de casos de Trastornos Neuróticos por año del periodo de estudio 2006-2016 (n=56.619) respecto a la población de afiliados en 2011.

Figura 2.. Distribución de la incidencia acumulada y de duraciones medias de incapacidad temporal por trastornos neuróticos superiores a la media nacional de Fraternidad-Muprespa (71,8 días) por provincias.

Figura 2.. Distribución de la incidencia acumulada y de duraciones medias de incapacidad temporal por trastornos neuróticos superiores a la media nacional de Fraternidad-Muprespa (71,8 días) por provincias.