Henk-Jan Boersema

112 Chapter 6 In our previous study we did not differentiate between the different diagnoses groups within the disease group mental and behavioural disorders as we were interested in the prevalence of (in)ability to work fulltime across different disease groups [15]. However, mental and behavioural disorders include a large variety of specific diagnoses groups, like mood disorders, stress disorders and delusional disorders, which all differ in degree and patterns of work capacity impairment [16,17,18]. Some mental and behavioural disorders can affect self-reliance, like delusional disorders and severe addictions, while other disorders may not have such an impact. On the other hand, there are disorders that may have an impact on energy levels (e.g., mood affective disorders, schizophrenia), which may impact capacities such as endurance, while other disorders more often cause emotional disturbance (e.g., personality disorders), and impair interactional capacities (contact behaviour, group integration, assertiveness). Different qualities and patterns of capacity impairments may impact the assessment of residual work capacity and inability to work fulltime [16,17,18]. It can be expected that individuals having a diagnosis that comes along with a decrease in self-reliance may show increased odds for being assessed with no residual work capacity, while diagnoses associated with reduced energy levels and fatigue may show increased odds for being assessed with inability to work fulltime. On the other hand, diagnoses more associated with emotional disturbances, may have a decreased risk for being assessed with both residual work capacity and inability to work fulltime. Therefore, each mental and behavioural disorder may show a different association with residual work capacity and inability to work fulltime, and different socio-demographic and disease-related factors within each disorder may be associated with both disability assessment outcomes. Many studies have been conducted to give more insight into the work ability description of workers with different mental and behavioural disorders. However, up to date, little is known about the prevalence of (no) residual work capacity and the (in)ability to work fulltime, two important aspects of the work disability benefit assessment in many European countries [13, 14], among workers diagnosed with a mental or behavioural disorder. Especially in employees diagnosed with these disorders, it is of great interest to distinguish between the types of diagnoses groups, since there is a large variety in the impact the different types of diagnoses have on the work capacity of these patients [16,17,18]. Additionally, for each diagnosis group, different sociodemographic characteristics and disease-related factors may be associated with (no) residual work capacity and (in)ability to work fulltime. Insight into these associations can contribute to a more evidence-based assessment of residual work capacity and inability to work fulltime in disability claim assessments, and may contribute to specify for which diagnoses groups supporting return to work is most useful.

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