Background: Claims for work-related mental health conditions (MHCs) are increasing. In Australia, general practitioners (GPs) see approximately 96% of injured workers, and play a key role in facilitating recovery for people with work-related MHCs. However, GPs have expressed difficulties with diagnosing and managing work-related MHCs. This is being addressed by the development of a 'Clinical Guideline for the Diagnosis and Management of Work-Related Mental Health Conditions in General Practice'. A key question to be addressed in this guideline is whether tools exist to assist in diagnosing such conditions.
Objectives: To identify clinical assessment tools, that can be used by GPs to facilitate the accurate diagnosis of work-related MHCs and their severity.
Methods: We undertook a systematic search of the literature in MEDLINE, EMBASE, PsycINFO, and CINAHL, using a combination of MeSH terms and keywords reflecting work-related MHCs, assessment tools, sensitivity and specificity, and general practice. The search was limited to papers published in English, with no set date limit. All identified tools were evaluated using the health-technology assessment criteria for patient-based outcome measures; for use in a narrative appraisal of the tools. Case screening and diagnostic classifications data were extracted for use in diagnostic accuracy testing (DAT); meta-analysis of sensitivity and specificity, or receiver operator curve, using tool cut-offs that indicate a positive screen/diagnosis or levels of severity.
Results: Sixty assessment tools were identified from 41 publications (38 studies). Twenty-three tools were not relevant to work-related MHCs and were therefore excluded. The thirty-seven remaining tools had limited reliability, validity, sensitivity and specificity testing in the work-related MHCs context, precluding DAT.
Conclusions: There are few studies that identify clinical assessment tools in the work-related MHC and general practice context. This limits the evidence base to support guideline recommendations for the diagnosis of MHCs and their severity in this context.