ITEM SELF-REPORT QUESTIONNAIRE, IN A WORKING POPULATION WITH AND WI...

50-item self-report questionnaire, in a working population with and without sickness absence dueto distress. Sensitivity and specificity were compared for various potential cutoff points, and areceiver operating characteristics analysis was conducted.Results and conclusion: A distress cutoff point of ≥11 was defined. The choice was based on achallenging specificity and negative predictive value and indicates a distress level at which anemployee is presumably at risk for subsequent sick leave on psychological grounds. The defineddistress cutoff point is appropriate for use in occupational health practice and in studies of distressin working populations.for men and 25.9% for women Distress and stress-relatedBackgroundDistress is a heterogeneously defined and imprecise termdisorders are widespread among working and non-work-ing populations and are responsible for high costs inthat refers to unpleasant subjective stress responses [1].terms of human suffering, disability and economic losses.Verhaak [2] estimated the prevalence in the general popu-lation in western communities as 15–25%. In a clinicalDespite the high prevalence and costly consequences, dis-population of cancer patients, Keller et al. [3] reportedtress still goes unrecognized by health professionals. Inclinically relevant distress in about 25% of patientsclinical settings comparing the patient-reported distress to(across other studies this figure ranges from 5% to 50%).the doctor's rating, the vast majority of the cases go unrec-In the working population, Bültmann et al. [4] docu-mented a prevalence of psychological distress as 21.8%ognized [5]. Although figures for occupational healthphysicians are unknown, we assume that these will bepared with 'care as usual'. Another study [29] amongsimilar to those in clinical settings.working employees showed that specific (preventive) cog-nitive and physical interventions are equally effective inreducing distress levels by 50–60%.The underrating of distress is not surprising since in healthcare the focus is not on distress, but on depression andIn the last two decades, several questionnaires have beenanxiety disorders and their consequences. Contrary to dis-tress, both disorders seem well-defined [6-9]. Both aredeveloped to measure distress. The Mood and AnxietySymptom Questionnaire (MASQ) established by Watsonhighly prevalent, contributing to almost 13% of the totaland Clark [9] and the Depression Anxiety Stress Scaleworld disease burden [10,11], ranging in different studies(DASS) originated by Lovibond and Lovibond [30] arefrom 12% to 49% for one-year prevalence rates and life-time prevalence for depression, and from 8% to 29% [12-based on the tripartite model of Clark and Watson [9].Recently, Terluin [7] introduced the Four Dimensional