[Life situation as a reason for sick leave].

The variation in general morbidity can not explain the observed variation in the incidence of sickness certification. 91% of patients who ask for a medical certificate for sick leave are granted the request, and it has been claimed that doctors often issue medical certificates because of the patients' social problems rather than their illness. We used a questionnaire to perform a survey of 1,401 consecutive adult patients who visited 89 general practitioners. 218 patients stated that they were given a medical certificate for sick leave. In 48 (22%) of these patients the doctors assessed that social and occupational factors influenced their decision to issue a medical certificate. In 34 patients occupational problems were stated as the reason, in five patients non-occupational problems, and in nine a combination of the two. According to the doctors, social problems were rarely the only reason for their issuing medical certificates for sick leave.