The impact of pain and depression on assessment of rehabilitation need: a cross-sectional study in long-term sick-listed patients.

The aim of this study was to examine the relationship between pain extent, severity of depressive symptoms and recommended rehabilitation measures in long-term sick-listed patients. In this cross-sectional study, the medical records of 228 long-term sick-listed patients consecutively referred to a multidisciplinary setting were examined retrospectively. Three specialists in psychiatry, orthopaedic surgery and rehabilitation medicine had made joint rehabilitation recommendations into the four different groups: (i) back to work without rehabilitation; (ii) vocational rehabilitation or adjusted work; (iii) medical rehabilitation and (iv) sick pension. Each patient filled in a pain drawing as a measure of pain extent and the self-administered Montgomery-Asberg-Depression-Rating Scale for evaluating the severity of depressive symptoms. Ninety-five percent of the patients had ongoing pain and 53% had depression. No statistically significant difference was seen between the outcome groups regarding the pain extent. A statistically significant difference was seen between the back to work without any rehabilitation and vocational rehabilitation or adjusted work groups in Montgomery-Asberg-Depression-Rating Scale score versus the medical-rehabilitation and sick-pension groups [P<0.001 between groups (chi(2) test); P<0.05 within groups (Tukey-Kramer Honestly Significant Difference test)]. In conclusion, two-thirds of the patients were assessed to need medical rehabilitation. These patient groups could be separated from the ones who were assessed to be able to go back to work without medical rehabilitation by the severity of the ongoing depression, but not by the pain extent alone. It was found that the combination of severity of depression and pain extent provided more information than the severity of depression alone.