Autonomic Activity, Pain, and Perceived Health in Patients on Sick Leave Due to Stress-Related Illnesses
MARINA HEIDEN, MARGARETA BARNEKOW-BERGKVIST, MINORI NAKATA, AND EUGENE LYSKOV Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden
Objective: The aim of the present study was to compare autonomic activity, pressure-pain thresholds, and subjective assessments of health and behavior between patients with stressrelated illnesses and healthy control subjects. Methods: Twenty sick-listed patients with stress-related illnesses and 20 age- and gender-matched healthy subjects performed tests of autonomic regulation and algometric tests, and completed questionnaires about physical and mental health and behavioral patterns. Results: Patients exhibited higher autonomic reactivity to cognitive and physical laboratory tasks ( p 0.05), and had lower pressure-pain thresholds in the shoulders and lower back than healthy control subjects ( p 0.05). Furthermore, the patients rated considerably poorer health and health behavior than the control subjects ( p 0.05). Conclusions: The results indicate an engagement of the autonomic nervous system in stress-related illnesses. Furthermore, they show that patients with stressrelated illnesses experience symptoms of musculoskeletal pain, and it is therefore recommended that assessments of musculoskeletal pain be incorporated in the clinical examinations and the rehabilitation of patients with stress-related illnesses.
Introduction AN INCREASING NUMBER OF EMPLOYEES are sick-listed due to stress-related illnesses, implying severe suffering for the affected individuals and large costs for society (Hurrell & Murphy, 1996; van der Klink & van Dijk, 2003). At present, a variety of subjective symptoms serve as a basis for diagnostics, whereas conclusive clinical criteria are not clearly formulated. There is therefore a great need for better understanding of specific clinical and pathogenic characteristics of these...