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Bjerregaard SS. Exploring predictors of welfare dependency 1, 3, and 5 years after mental health-related absence in danish municipalities between 2010 and 2012 using flexible machine learning modelling. BMC Public Health 2023; 23:224. [PMID: 36732716 PMCID: PMC9893621 DOI: 10.1186/s12889-023-15106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Using XGBoost (XGB), this study demonstrates how flexible machine learning modelling can complement traditional statistical modelling (multinomial logistic regression) as a sensitivity analysis and predictive modelling tool in occupational health research. DESIGN The study predicts welfare dependency for a cohort at 1, 3, and 5 years of follow-up using XGB and multinomial logistic regression (MLR). The models' predictive ability is evaluated using tenfold cross-validation (internal validation) and geographical validation (semi-external validation). In addition, we calculate and graphically assess Shapley additive explanation (SHAP) values from the XGB model to examine deviation from linearity assumptions, including interactions. The study population consists of all 20-54 years old on long-term sickness absence leave due to self-reported common mental disorders (CMD) between April 26, 2010, and September 2012 in 21 (of 98) Danish municipalities that participated in the Danish Return to Work program. The total sample of 19.664 observations is split geospatially into a development set (n = 9.756) and a test set (n = 9.908). RESULTS There were no practical differences in the XGB and MLR models' predictive ability. Industry, job skills, citizenship, unemployment insurance, gender, and period had limited importance in predicting welfare dependency in both models. On the other hand, welfare dependency history and reason for sickness absence were strong predictors. Graphical SHAP-analysis of the XGB model did not indicate substantial deviations from linearity assumptions implied by the multinomial regression model. CONCLUSION Flexible machine learning models like XGB can supplement traditional statistical methods like multinomial logistic regression in occupational health research by providing a benchmark for predictive performance and traditional statistical models' ability to capture important associations for a given set of predictors as well as potential violations of linearity. TRIAL REGISTRATION ISRCTN43004323.
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Affiliation(s)
- Søren Skotte Bjerregaard
- The National Research Centre for the Working Environment, 105 Lersø Parkallé, DK-2100, Copenhagen, Denmark.
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2
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Wijkander M, Farrants K, Magnusson Hanson LL. Exposure to work-related violence and/or threats of violence as a predictor of certified sickness absence due to mental disorders: a prospective cohort study of 16,339 Swedish men and women in paid work. Int Arch Occup Environ Health 2023; 96:225-236. [PMID: 36070001 PMCID: PMC9905169 DOI: 10.1007/s00420-022-01917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this prospective cohort study was to investigate if exposure to work-related violence and/or threats of violence predict certified sickness absence due to mental disorders. METHODS Information on work-related exposure to violence and/or threats of violence were derived from the biannual Swedish Longitudinal Occupational Survey of Health (SLOSH) study 2012-2016, including individuals in paid work across Sweden and from different occupations/sectors (n = 16,339). Certified sickness absence due to mental disorders were ascertained from register data from the Swedish Social Insurance Agency. Odds ratios of certified sickness absence due to mental disorders according to exposure to work-related violence were estimated using multiple logistic regression. Several potential confounding variables, such as demographic and socio-economic factors, age, sex, cohabitation, children living at home, socio-economic status, educational level, as well as other types of psychosocial work environmental factors, were adjusted for in the analyses. RESULTS In the total study sample, 9% reported exposure to violence and/or threats of violence and the prevalence of sickness absence due to mental disorders was 5%. Exposure to work-related violence and/or threats of violence was associated prospectively with certified sickness absence due to mental disorders (odds ratio 1.46, 95% confidence interval 1.17-1.82, p < 0.01). Analysis of possible interaction showed no difference in association when comparing women to men and different age groups. CONCLUSIONS Exposure to work-related violence and/or threats of violence appear to increase the odds of certified sickness absence due to mental disorders. Preventive measures aiming to lower the risk of exposure is thus of great importance.
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Affiliation(s)
- Maria Wijkander
- Stress Research Institute, Department of Psychology, Stockholm University, 10691, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Linda L Magnusson Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, 10691, Stockholm, Sweden.
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Hannerz H, Flyvholm MA. Do baseline industry and job group skill level predict welfare dependency at 1, 3 and 5 years after mental health related sickness absence? A Danish cohort study. BMC Public Health 2022; 22:697. [PMID: 35397597 PMCID: PMC8994387 DOI: 10.1186/s12889-022-13105-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background The cost of mental ill health in the EU-28 nations has been estimated at approximately 4.1% of the total gross domestic products (GDP). Improved rates of return to sustainable employment among people who are sick-listed due to mental ill health would decrease spending on welfare benefits. The present cohort study provides statistical information that may be helpful in the design and prioritizing of efforts aimed at reducing the burden of sickness absence due to mental ill health among employees in the general working population of Denmark. Our primary aim was to estimate odds of being i) deceased or recipient of health related welfare benefits and ii) recipient non-health related welfare benefits, compared to being alive and self-reliant at 1, 3 and 5 years after first visit to a jobs and benefits office due to mental health related sickness absence, as a function of industrial sector and job group skill level at baseline. A secondary aim was to analyze these odds as a function of baseline age, gender, type of mental ill health, family type and employment status. Methods The study population consisted of 20–54 year-old persons on long-term sickness absence due to mental health problems in 21 Danish municipalities in 2010–2012 (N = 19,660). Odds ratios were estimated by use of multinomial logistic regression. The outcomes were ascertained through national registers. Results We did not find any statistically significant association between baseline industrial sector or job group skill level and welfare dependency at follow-up. In the secondary analyses, the estimated odds of health and non-health related welfare dependencies at follow-up tended to increase with unemployment, age, being single and being on sick leave due to self-reported anxiety or depression versus stress/burnout at baseline. Conclusions The present study does not support that industry and job group skill level predict welfare dependency after health related sickness absence, after adjustment for relevant covariates, in the general population of Denmark. It suggests, however, that the vulnerability lies in population groups characterized by unemployment, older age, being single and being on sick leave due to self-reported anxiety or depression versus stress/burnout.
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Ropponen A, Narusyte J, Wang M, Kärkkäinen S, Mather L, Blom V, Bergström G, Svedberg P. Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach. Int Arch Occup Environ Health 2021; 95:867-876. [PMID: 34962585 PMCID: PMC9038880 DOI: 10.1007/s00420-021-01825-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022]
Abstract
Purpose To investigate associations between social benefits and disability pension (DP), long-term sickness absence (LTSA, ≥ 90 days), or unemployment among Swedish twins with sickness absence (SA) due to mental diagnoses. Methods This population-based prospective twin study included register data on first incident SA spell (< 90 days) due to mental diagnoses (ICD 10 codes F00-F99) during the follow-up 2005–2016. SA < 90 days due to other diagnoses than mental diagnoses or any other social insurance benefit was identified for the preceding year of the first incident SA spell due to mental diagnoses (coded yes/no). Comparing those with any previous social benefits vs without, cumulative incidence curve to compare time to an event, and Cox proportional hazards models for cause-specific hazard ratios (HR, 95% confidence intervals, CI) treating first incident DP, LTSA and unemployment as competing risks were modeled. Results During follow-up, 21 DP, 1619 LTSA, and 808 unemployment events took place. Compared to those without, those with at least one benefit had a higher risk for DP (HR 5.03; 95%CI 1.80, 14.01), LTSA (1.67; 1.50, 1.84) and unemployment (1.24; 1.03, 1.50). The cumulative incidence for DP was very low, < 1%, for LTSA 80% with any previous social benefits vs. 60% without, and for unemployment ≤ 5%. Conclusion Social benefits received during the preceding year of SA due to mental diagnoses (< 90 days) predict DP, LTSA, and unemployment. Hence, previous social benefits may provide means for early identification of persons at risk for exit from labor market.
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Affiliation(s)
- Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden. .,Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.,Center of Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Sanna Kärkkäinen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.,Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lisa Mather
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Victoria Blom
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.,The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Gunnar Bergström
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Occupational Health Sciences and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
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Resilience building for mood disorders: Theoretical introduction and the achievements of the Re-Work program in Japan. Asian J Psychiatr 2021; 58:102580. [PMID: 33631538 DOI: 10.1016/j.ajp.2021.102580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 12/20/2022]
Abstract
Mood disorders are common, tend to recur, cause sickness absence, and lead to economic loss. Since past experiences of mood disorder episodes often increase future vulnerability, it is imperative to assist those mood disorder patients who want to resume working to build resilience to prevent relapse. Paralleling efforts in the West, a resilience-building program utilizing the principles of the Illness Management and Recovery program was first developed in Japan in 1997. The purpose of this survey is to introduce the concept and theory behind the Re-Work program and to review studies that report on program assessment, content, effects and associated factors, and prognosis of participants. A literature search performed with PubMed and Igaku chuou zasshi (Ichushi) identified 30 relevant studies. One of these reported on a tool developed to assess readiness for returning to work. Concerning program content, a group therapy setting and cognitive behavioral therapy were found to be effective. Physical exercise and relaxation techniques may be useful as secondary program components. Several studies report on program effects, but there may be factors that limit these effects. The prognosis for relapse prevention after the resumption of work may be better for Re-Work program participants than for a control group. Further research in this area is needed to confirm program effectiveness and related factors.
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Knapstad M, Sæther SMM, Hensing G, Smith ORF. Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment. BMC Health Serv Res 2020; 20:85. [PMID: 32019521 PMCID: PMC7001227 DOI: 10.1186/s12913-020-4932-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety and depression are associated with substantial functional impairment. Prompt Mental Health Care (PMHC), the Norwegian adaptation of IAPT is currently piloted across Norway, as a means to improve access to evidence-based care for adults with anxiety disorders (including subthreshold cases) and minor to moderate depression. The aims of the current paper were to examine the change in work status and functional status from pre- to post-treatment and 12 months post-treatment among clients at the first 12 PMHC pilot sites, and whether degree of change differed across sociodemographic characteristics. METHODS A prospective cohort design was used, including working age clients receiving treatment between October 2014 and December 2016 (n = 1446, participation rate = 61%). Work status and functional status were self-reported, the latter by the Work and Social Adjustment Scale (WSAS). Changes in work status and WSAS score were examined through multilevel models based on maximum likelihood estimation. Likelihood ratio tests were performed to determine whether the interaction between time and the respective background variables were statistically significant. RESULTS A substantial increase in regular work participation was observed from pre- to post-treatment, which further had increased at 12 months post-treatment. The increase was driven by a corresponding reduction in proportion of clients working and receiving benefits (OR 0.38 [0.29-0.50] baseline to final treatment, OR = 0.19 [0.12-0.32] final treatment to 12-months post-treatment), while no statistically significant change was observed in proportion out of work. Large improvement (ES = - 0.89) in WSAS score was observed from pre- to post treatment. WSAS score at 12 months post-treatment remained at the post-treatment level. CONCLUSIONS Previous research has shown substantial symptom improvement among clients receiving treatment in PMHC. The current findings indicate that PMHC might also be able to aid adults struggling with mild to moderate anxiety and depression in returning to usual level of functioning. The degree to which the observed improvements are attributable to the treatment need nonetheless to be confirmed in a trial including a control group and with more complete follow-up data from registries.
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Affiliation(s)
- Marit Knapstad
- Department of Clinical Psychology, University of Bergen, P.B. 7807, N-5020, Bergen, Norway. .,Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gate 7, N-5015, Bergen, Norway.
| | | | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Otto Robert Frans Smith
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gate 7, N-5015, Bergen, Norway
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Rahman S, Mittendorfer-Rutz E, Dorner TE, Pazarlis K, Ropponen A, Svedberg P, Wang M, Helgesson M. Work-disability in low back pain patients with or without surgery, and the role of social insurance regulation changes in Sweden. Eur J Public Health 2019; 29:524-530. [PMID: 30445623 DOI: 10.1093/eurpub/cky243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aims were to study the differences in work-disability in patients with low back pain (LBP) in relation to (i) treatment provided (non-surgical or lumber spine surgery (decompression or fusion), and (ii) two time points, i.e. before and after the social insurance regulation changes in the in 2008. METHODS All non-pensioned individuals, aged 19-60 years, living in Sweden, diagnosed with LBP in 2004-06 or 2008-10 were included (n = 153739). Hazard ratios (HRs) with 95% confidence intervals for long-term sickness absence (>90 days, LTSA) and disability pension (DP) for LBP-patients (non-surgical, decompression, fusion, both surgeries) were estimated by Cox regression compared with the matched references from the general population without LBP (n = 566008). RESULTS LBP-patients had a higher risk of subsequent work-disability compared with the references before and after insurance regulation changes. LBP-patients receiving decompression surgery had similar risk for later work-disability as those treated non-surgically. However, following regulation changes, LBP-patients undergoing fusion surgery had higher risk estimates of both LTSA (HR: 3.3) and DP (HR: 4.8) than patients treated non-surgically (HR: LTSA 2.1; DP 2.5) or with decompression (HR: LTSA 2.6; DP 2.1). In the adjusted models, risk estimates mainly attenuated after controlling for previous sickness absence. CONCLUSION Risk for subsequent work-disability among LBP-patients was higher compared with people without LBP and lumbar spine surgery. Discrepancies in risk were explained by the treatment provided previous sickness absence and changes in the social insurance regulations, specifically LBP-patients treated with fusion surgery had an increased risk of subsequent work-disability after changes in regulations.
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Affiliation(s)
- Syed Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Wien, Austria
| | - Konstantinos Pazarlis
- Division of Orthopaedics, Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Finnish Institute of Occupational Health, Työterveyslaitos, Finland
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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8
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Sakakibara S, Sado M, Ninomiya A, Arai M, Takahashi S, Ishihara C, Miura Y, Tabuchi H, Shirahase J, Mimura M. Predictive factors of the duration of sick leave due to mental disorders. Int J Ment Health Syst 2019; 13:19. [PMID: 30976299 PMCID: PMC6441213 DOI: 10.1186/s13033-019-0279-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to examine potential predictors of duration of sick leave due to mental disorders in Japan. Methods A total of 207 employees at a manufacturing company in Japan with a past history of sick leave due to mental disorders participated in this study. Mental disorders were defined as those listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). All of the participants used the mental health program that the company provided. The predictive power of the variables was tested using a Cox proportional hazard analysis. The hazard ratios in the final model were used to identify the predictor variables of the duration of sick leave. We included socio-demographic (age, sex, tenure), clinical (diagnosis and number of previous sick leave), and work-related factors (employment rank) as possible predictors. Data on these variables were obtained through the psychiatrists and psychologists in the company’s mental health program. Results The results of the univariate analyses showed that the number of previous sick leave episodes, diagnosis and employee rank were significant predictors of the duration of sick leave due to mental disorders. A multivariate analysis indicated that age, number of previous sick leave and employee rank were statistically significant predictors of return to work. Conclusions Diagnosis, number of previous sick leave episodes, and employee rank are predictors of the duration of sick leave due to mental disorders. This study’s findings have implications in the development of effective interventions to prevent protracted sick leave.
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Affiliation(s)
- Sawako Sakakibara
- 1Center for Counseling and Disability Services, Tohoku University, Sendai, Japan
| | - Mitsuhiro Sado
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Akira Ninomiya
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Mayuko Arai
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Satoko Takahashi
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Chika Ishihara
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Yuki Miura
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Hajime Tabuchi
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Joichiro Shirahase
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
| | - Masaru Mimura
- 2Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582 Japan.,3Center for Stress Research, Keio University, Tokyo, Japan
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9
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Wang M, Vaez M, Dorner TE, Rahman S, Helgesson M, Ivert T, Mittendorfer-Rutz E. Risk factors for subsequent work disability in patients with acute myocardial infarction. Eur J Public Health 2019; 29:531-540. [DOI: 10.1093/eurpub/cky279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marjan Vaez
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Ernst Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Syed Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Torbjörn Ivert
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Muschalla B, Henning A, Haake TW, Cornetz K, Olbrich D. Mental health problem or workplace problem or something else: what contributes to work perception? Disabil Rehabil 2018; 42:502-509. [PMID: 30451011 DOI: 10.1080/09638288.2018.1501099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Work perception is an important predictor for work ability and, therefore, of interest for rehabilitation. Until now it is unclear to which extent different psychological aspects explain work perception. This study investigates in which way workplace problems on the one hand, and mental health and coping on the other hand, contribute to work perception.Methods: A heterogeneous sample of 384 persons in working age with and without mental health problems was recruited. Participants gave self-reports on workplace problems, mental health problems, work-coping, work-anxiety, and work perception.Results: Persons with mental health problems and workplace problems (M + W) perceive the highest degree of work demands, followed by persons with workplace problems but without mental health problems (NM + W). Work-anxiety appeared as the strongest factor explaining perception of high work demands, whereas general mental health problems did not contribute significantly to variance explanation.Conclusions: Persons with specific mental health problems in terms of work-anxiety may be expected to perceive higher work demands. They may be detected when asking for work perception, e.g., within the frame of return-to-work interventions in rehabilitation, or in occupational health settings by mental hazard analysis.Implications for rehabilitationWork perception is an important predictor for work ability. Work-anxiety plays a key role for work perception. Thus, work perception and work anxiety should be explored in the diagnostic phase of rehabilitation treatments.Work-anxiety should be considered not only in rehabilitation diagnostics and interventions in clinical settings, but considered in preventive activities at work: Self-ratings on work-anxiety and work perception (instead of general wellbeing) may be included in assessments for workplace exploration, or mental hazard analysis. They give hints concerning concrete work-related health problems.
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Affiliation(s)
- Beate Muschalla
- Department of Psychology, Technische Universität Braunschweig, Braunschweig, Germany
| | - Anne Henning
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
| | - Tim Woody Haake
- Department of Psychology, University Potsdam, Potsdam, Germany
| | - Kathrin Cornetz
- Department of Psychology, University Potsdam, Potsdam, Germany
| | - Dieter Olbrich
- Department Psychosomatic, Rehabilitation Center Bad Salzuflen, Bad Salzuflen, Germany
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11
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Marco JH, Alonso S, Andani J. Early intervention with cognitive behavioral therapy reduces sick leave duration in people with adjustment, anxiety and depressive disorders. J Ment Health 2018; 29:247-255. [PMID: 30322314 DOI: 10.1080/09638237.2018.1521937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Early intervention in workers diagnosed with mental disorders is associated with a lower incidence of relapse and shorter sick leave. However, no studies have been carried out on the effect of early intervention using an evidence-based therapy, Cognitive Behavioral Therapy (CBT), on people with sick leave.Aims: The objectives of the present study are to study whether the type of intervention (early or late) will affect the total duration of the sick leave, the partial duration of the sick leave, the duration of the psychotherapy and the time until return to work after the psychotherapy ends. The sample was composed of 167 participants who were on sick leave for adjustment disorders, anxiety disorders or depressive disorder.Results: The participants who had early intervention with CBT had a significantly shorter duration of total sick leave and partial sick leave, and a shorter time until returning to work after the psychotherapy ended than those who had late intervention. There were no statistically differences in the duration or efficacy of the psychotherapy.Conclusion: We can suggest that providing early access to CBT significantly reduces the length of sick leave in patients with mental disorders.
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Affiliation(s)
- José H Marco
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Sandra Alonso
- Doctoral School of Catholic University of Valencia, Saint Vincent Martyr, Valencia, Spain.,Cathedra UMIVALE Innovation and Research in Pathology Work, Valencia, Spain
| | - Joaquín Andani
- Cathedra UMIVALE Innovation and Research in Pathology Work, Valencia, Spain.,Catholic University of Valencia, Saint Vincent Martyr, Valencia, Spain
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de Vries H, Fishta A, Weikert B, Rodriguez Sanchez A, Wegewitz U. Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:393-417. [PMID: 28980107 PMCID: PMC6096498 DOI: 10.1007/s10926-017-9730-1] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Purpose To present an overview of the existing evidence on prognostic factors of (recurrent) sickness absence (SA) and return to work (RTW) among workers with a common mental disorder (CMD). This scoping review provides information about determinants for SA and RTW, which could be used to develop better interventions aimed at the prevention of SA and promotion of RTW among workers with a CMD. Methods Relevant articles were identified in PubMed, Embase, PsycINFO, PSYNDEX, and SINGLE up to October 2016. In order to be included, studies should provide insight into prognostic factors of SA or RTW of workers with a CMD. We classified all factors according to the domains of the International Classification of Functioning, Disability and Health. Results Our searches identified 2447 possible relevant articles, of which 71 were included for data extraction. There is consistent evidence in ≥3 studies that previous episodes of CMD, higher symptom severity, previous absenteeism, co-morbidity, high job demands, low job control, high job strain, female gender, lower educational level, smoking behavior, and low perceived general health are predictors of SA in people with CMDs. Earlier RTW is consistently predicted by lower symptom severity, having no previous absenteeism, younger age, and positive expectations concerning sick-leave duration or RTW. Conclusions The amount of research on determinants for SA and RTW in workers with CMD has increased dramatically in recent years, although most studies are from the Netherlands and Scandinavia. There are some research gaps identified in this scoping review that need further attention in primary and secondary studies. Based on the summary of the evidence, we provide guidance for policy, practice and research.
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Affiliation(s)
- Haitze de Vries
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Postbus 30001, 9700 RB, Groningen, The Netherlands.
| | - Alba Fishta
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Beate Weikert
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Alejandra Rodriguez Sanchez
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Uta Wegewitz
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
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13
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Wang M, Mittendorfer-Rutz E, Dorner TE, Pazarlis KA, Ropponen A, Svedberg P, Helgesson M. Determinants of work disability following lumbar spine decompression surgery. Scand J Public Health 2018; 47:281-292. [PMID: 29974820 DOI: 10.1177/1403494818785055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Scientific knowledge about risk factors for work disability in terms of long-term sickness absence and disability pension following lumbar spine decompression surgery remains insufficient. This study aimed to investigate the associations between socio-demographic, work-related, and medical characteristics with subsequent long-term sickness absence (>90 days) and disability pension for individuals who underwent lumbar spine decompression surgery. METHODS A prospective cohort study of all individuals aged 19-60 years with diagnosed dorsopathies, who underwent lumbar spine decompression surgery 2008-10 in Sweden ( n=7373) was performed. Univariate and multivariate hazard ratios with 95% confidence intervals regarding long-term sickness absence and disability pension with a 3-year follow-up period were estimated by Cox proportional regression. RESULTS Low educational level, being a non-European immigrant and preoperative sickness absence were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.8). Female sex was a risk factor for long-term sickness absence (hazard ratios: 1.3) whereas age >44 years and being a Nordic immigrant were risk factors for disability pension (hazard ratios: 1.9-2.6). Medical factors as common mental disorders, other mental disorders, prescribed psychiatric medication and somatic comorbidity were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.4). A simultaneous lumbar fusion surgery and high preoperative pain severity were risk factors for long-term sickness absence (hazard ratios 1.2-1.8). CONCLUSIONS To prevent long-term work disability after lumbar spine decompression surgery, specific focus is required on older and female patients, those with mental or somatic comorbidities, high levels of preoperative pain or sickness absence, with a simultaneous lumbar fusion surgery, a low educational level or a non-European immigrant background.
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Affiliation(s)
- Mo Wang
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | | | - Thomas E Dorner
- 2 Department of Social and Preventive Medicine, Medical University of Vienna, Austria
| | | | - Annina Ropponen
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,4 Finnish Institute of Occupational Health, Finland
| | - Pia Svedberg
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Magnus Helgesson
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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14
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Salonen L, Blomgren J, Laaksonen M, Niemelä M. Sickness absence as a predictor of disability retirement in different occupational classes: a register-based study of a working-age cohort in Finland in 2007-2014. BMJ Open 2018; 8:e020491. [PMID: 29743328 PMCID: PMC5942421 DOI: 10.1136/bmjopen-2017-020491] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The objective of the study was to examine diagnosis-specific sickness absences of different lengths as predictors of disability retirement in different occupational classes. DESIGN Register-based prospective cohort study up to 8 years of follow-up. PARTICIPANTS A 70% random sample of the non-retired Finnish population aged 25-62 at the end of 2006 was included (n=1 727 644) and linked to data on sickness absences in 2005 and data on disability retirement in 2007-2014. MAIN OUTCOME MEASURES Cox proportional hazards regression was utilised to analyse the association of sickness absence with the risk of all-cause disability retirement during an 8-year follow-up. RESULTS The risk of disability retirement increased with increasing lengths of sickness absence in all occupational classes. A long sickness absence was a particularly strong predictor of disability retirement in upper non-manual employees as among those with over 180 sickness absence days the HR was 9.19 (95% CI 7.40 to 11.40), but in manual employees the HR was 3.51 (95% CI 3.23 to 3.81) in men. Among women, the corresponding HRs were 7.26 (95% CI 6.16 to 8.57) and 3.94 (95% CI 3.60 to 4.30), respectively. Adjusting for the diagnosis of sickness absence partly attenuated the association between the length of sickness absence and the risk of disability retirement in all employed groups. CONCLUSIONS A long sickness absence is a strong predictor of disability retirement in all occupational classes. Preventing the accumulation of sickness absence days and designing more efficient policies for different occupational classes may be crucial to reduce the number of transitions to early retirement due to disability.
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Affiliation(s)
- Laura Salonen
- Department of Social Research, University of Turku, Turku, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland (KELA), Helsinki, Finland
| | | | - Mikko Niemelä
- Department of Social Research, University of Turku, Turku, Finland
- The Social Insurance Institution of Finland (KELA), Helsinki, Finland
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15
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Mid-life psychosocial work environment as a predictor of work exit by age 50. PLoS One 2018; 13:e0195495. [PMID: 29621353 PMCID: PMC5886550 DOI: 10.1371/journal.pone.0195495] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 03/24/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To examine whether psychosocial work characteristics at age 45 years predict exit from the labour market by the age of 50 years in data from the 1958 British Birth Cohort. METHODS Psychosocial work characteristics (decision latitude, job demands, job strain and work social support at 45 years and job insecurity at 42 years) measured by questionnaire were linked to employment outcomes (unemployment, retirement, permanent sickness, homemaking) at 50 years in 6510 male and female participants. RESULTS Low decision latitude (RR = 2.01, 95%CI 1.06,3.79), low work social support (RR = 1.96, 95%CI 1.12,3.44), and high job insecurity (RR = 2.27, 95%CI 1.41, 3.67) predicted unemployment at 50, adjusting for sex, housing tenure, socioeconomic status, marital status, and education. High demands were associated with lower risk of unemployment (RR = 0.50, 95%CI 0.29,0.88) but higher risk of permanent sickness (RR = 2.14, 95%CI 1.09,4.21). CONCLUSIONS Keeping people in the workforce beyond 50 years may contribute to both personal and national prosperity. Employers may wish to improve working conditions for older workers, in particular, increase control over work, increase support and reduce demands to retain older employees in the workforce.
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16
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Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden. BMC Public Health 2017; 17:931. [PMID: 29202827 PMCID: PMC5716008 DOI: 10.1186/s12889-017-4944-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In several countries, immigrants have higher disability pension (DP) rates than natives. Reasons for this are poorly understood. The aim of this study was to investigate if the risk of diagnosis-specific DP differed in first, second, and second/intermediate generation immigrants compared to natives, in general and across regions of birth, and stratified by age. METHODS A population-based prospective cohort study of all 3,507,055 individuals aged 19-50 years and living in Sweden in 2004 with a 6-year follow-up period. Hazard ratios (HR) and 95% confidence intervals (CI) for mental and somatic DP were estimated by Cox regression for first, second, and second/intermediate generation immigrants compared to natives, across regions of birth and stratified by age. RESULTS After multivariate adjustment, HRs for both mental and somatic DP were higher at follow-up in the first generation compared to natives: mental HR 1.17 (CI 1.12-1.22) and somatic 1.15 (1.09-1.22) for individuals <35 years; 1.74 (1.69-1.79) and 1.70 (1.66-1.74) ≥35 years (median), respectively. Immigrants born in Europe outside EU25, and countries outside Europe had particularly elevated HRs. Also in the second generation, HRs were higher in mental 1.29 (1.21-1.37) and somatic DP: 1.30 (1.19-1.42) in those <35 years; and 1.18 (1.10-1.27); and 1.10 (1.03-1.17) for those ≥35 years, respectively. Among second generation immigrants there were no strong differences in HRs between regions of birth. CONCLUSIONS Compared to natives, the risk of DP was higher in first and second generation immigrants. Higher estimates were seen for immigrants from Europe outside EU25 and from the rest of the world in the first generation. No considerable differences in estimates regarding mental or somatic DP diagnoses were found.
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17
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Alonso S, Marco JH, Andani J. Reducing the time until psychotherapy initiation reduces sick leave duration in participants diagnosed with anxiety and mood disorders. Clin Psychol Psychother 2017; 25:138-143. [PMID: 28833894 DOI: 10.1002/cpp.2134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 07/27/2017] [Accepted: 07/31/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sick leave in patients with a mental disorder is characterized by having a long duration. Studies suggest that the time until a patient on sick leave for a common mental health disorder initiates evaluation and treatment by a healthcare professional is an important factor in the duration of the sick leave. However, in these studies, the intervention was not performed by a mental health specialist. The aim of this study was to find out whether the length of sick leave was associated with the time before initiating psychotherapy, age, time until returning to work after psychotherapy ends, and duration of psychotherapy. In a further analysis, we examined whether the model composed of age, duration of psychotherapy, and time before initiating psychotherapy predicted the length of sick leave. METHOD The sample consisted of 2,423 participants, 64.1% (n = 1,554) women and 35.9% (n = 869) men, who were on sick leave for anxiety disorders or depressive disorder. RESULTS The total duration of the sick leave of participants diagnosed with depression and anxiety was positively associated with the time before beginning psychotherapy. Time before beginning psychotherapy predicted the length of sick leave when the variables age and duration of psychotherapy were controlled. CONCLUSION It is necessary to reduce the time until beginning psychotherapy in people on sick leave for common mental disorders.
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Affiliation(s)
- Sandra Alonso
- Catholic University of Valencia Saint Vincent Martyr, Valencia, Spain.,Cathedra UMIVALE Innovation and Research in Pathology Work, Valencia, Spain
| | - José H Marco
- Catholic University of Valencia Saint Vincent Martyr, Valencia, Spain
| | - Joaquín Andani
- Catholic University of Valencia Saint Vincent Martyr, Valencia, Spain.,Cathedra UMIVALE Innovation and Research in Pathology Work, Valencia, Spain
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18
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Gabbay M, Shiels C, Hillage J. The issue of "long-term" fit notes for depression in the UK: patient, GP and general practice variation. J Ment Health 2017; 29:657-664. [PMID: 28686477 DOI: 10.1080/09638237.2017.1340620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Depression is an important cause of certified sickness absence in the UK. It is not known what factors are associated with variation in length of sickness certificates issued by the GP to the depressed patient.Aims: The purpose of the study was to identify patient, GP and practice factors associated with the issue of a long-term (> 4 week) fit note for depression.Methods: Sixty-eight UK general practices collected sickness certification data for 12 months.Results: Over 35% of 8127 fit notes issued to 3361 patients for depression were classed as long-term (over four weeks in duration). Having previous fit notes for depression, not having "may be fit" advice on the fit note, older patient age, the patient living in a deprived neighbourhood and a higher practice deprivation status were all significant predictors of a long-term fit note. Depression fit notes issued by female GPs to female patients were less likely to be long-term. Other GP factors were not significant predictors of a long-term depression note.Conclusions: Reducing the number of long-term sickness certificates issued to people with depression should be considered part of return-to work and job retention strategies.
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Affiliation(s)
- Mark Gabbay
- Department of Health Services Research, University of Liverpool, Liverpool, UK and
| | - Chris Shiels
- Department of Health Services Research, University of Liverpool, Liverpool, UK and
| | - Jim Hillage
- Institute for Employment Studies, Brighton, UK
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19
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van Beurden KM, Joosen MCW, Terluin B, van Weeghel J, van der Klink JJL, Brouwers EPM. Use of a mental health guideline by occupational physicians and associations with return to work in workers sick-listed due to common mental disorders: a retrospective cohort study. Disabil Rehabil 2017; 40:2623-2631. [DOI: 10.1080/09638288.2017.1347209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Karlijn M. van Beurden
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Margot C. W. Joosen
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Berend Terluin
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Board of Directors, Phrenos Centre of Expertise, Utrecht, The Netherlands
- Parnassia Group, Dijk en Duin Mental Health Center, Castricum, The Netherlands
| | - Jac J. L. van der Klink
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Netherlands School of Public & Occupational Health, Utrecht, The Netherlands
| | - Evelien P. M. Brouwers
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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20
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Norder G, Roelen CAM, van der Klink JJL, Bültmann U, Sluiter JK, Nieuwenhuijsen K. External Validation and Update of a Prediction Rule for the Duration of Sickness Absence Due to Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:202-209. [PMID: 27260170 PMCID: PMC5405096 DOI: 10.1007/s10926-016-9646-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Purpose The objective of the present study was to validate an existing prediction rule (including age, education, depressive/anxiety symptoms, and recovery expectations) for predictions of the duration of sickness absence due to common mental disorders (CMDs) and investigate the added value of work-related factors. Methods A prospective cohort study including 596 employees who reported sick with CMDs in the period from September 2013 to April 2014. Work-related factors were measured at baseline with the Questionnaire on the Experience and Evaluation of Work. During 1-year follow-up, sickness absence data were retrieved from an occupational health register. The outcome variables of the study were sickness absence (no = 0, yes = 1) at 3 and 6 months after reporting sick with CMDs. Discrimination between workers with and without sickness absence was investigated at 3 and 6 months with the area under the receiver operating characteristic curve (AUC). Results A total of 220 (37 %) employees agreed to participate and 211 (35 %) had complete data for analysis. Discrimination was poor with AUC = 0.69 and AUC = 0.55 at 3 and 6 months, respectively. When 'variety in work' was added as predictor variable, discrimination between employees with and without CMD sickness absence improved to AUC = 0.74 (at 3 months) and AUC = 0.62 (at 6 months). Conclusions The original prediction rule poorly predicted CMD sickness absence duration. After adding 'variety in work', the prediction rule discriminated between employees with and without CMD sickness absence 3 months after reporting sick. This new prediction rule remains to be validated in other populations.
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Affiliation(s)
- Giny Norder
- ArboNed Occupational Health Service, PO Box 85091, 3508 AB, Utrecht, The Netherlands.
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Corné A M Roelen
- ArboNed Occupational Health Service, PO Box 85091, 3508 AB, Utrecht, The Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jac J L van der Klink
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ute Bültmann
- ArboNed Occupational Health Service, PO Box 85091, 3508 AB, Utrecht, The Netherlands
| | - J K Sluiter
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K Nieuwenhuijsen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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21
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de Weerd BJ, van Dijk MK, van der Linden JN, Roelen CAM, Verbraak MJPM. The effectiveness of a convergence dialogue meeting with the employer in promoting return to work as part of the cognitive-behavioural treatment of common mental disorders: A randomized controlled trial. Work 2017; 54:647-55. [PMID: 27286071 DOI: 10.3233/wor-162307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Dialogue between supervisor and employee is of great importance for occupational rehabilitation. OBJECTIVE To evaluate the effectiveness of a convergence dialogue meeting (CDM) of employee, therapist and supervisor aimed at facilitating return to work (RTW) as part of cognitive-behavioural treatment. METHODS Randomized controlled trial including 60 employees sick-listed with common mental disorders and referred for specialized mental healthcare. Employees were randomly allocated either to an intervention group (n = 31) receiving work-focused cognitive-behavioural therapy plus CDM or a control group (n = 29) receiving work-focused cognitive-behavioural therapy without CDM. RESULTS The time to first RTW was 12 days shorter (p = 0.334) in the intervention group, although full (i.e., at equal earnings as before reporting sick) RTW took 41 days longer (p = 0.122) than the control group. The odds of full RTW at the end of treatment were only 7% higher (p = 0.910) in the intervention group as compared to the control group. CONCLUSIONS CDM did not significantly reduce the time to RTW. We recommend that therapists who are trained on CDM focus on barriers and solutions for RTW.
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Affiliation(s)
| | | | | | | | - Marc J P M Verbraak
- Radboud Centre Social Sciences, Radboud University and Pro Persona, Nijmegen, The Netherlands
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22
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Victor M, Lau B, Ruud T. Patient characteristics in a return to work programme for common mental disorders: a cross-sectional study. BMC Public Health 2016; 16:745. [PMID: 27502950 PMCID: PMC4977655 DOI: 10.1186/s12889-016-3431-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 08/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background Mental health problems are a growing cause of sickness absence. There are programmes in many countries to facilitate return to work (RTW) after sickness absence. In Norway, there has been some controversy about patients on sick-leave being prioritized over other patient groups, such as those with more severe diagnoses. However, it is not clear whether patients in RTW programmes actually do differ from patients in regular services. Methods This study compared 270 patients treated in an RTW outpatient clinic and 86 patients treated in a regular outpatient clinic, both in specialized mental health care, on patient characteristics, history of treatment and mental health status. Analyses of differences between groups were done by ANOVA tests, chi-square test and logistic regression. Results Patients in the RTW clinic had lower scores on the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). There was no difference in health-related quality of life. RTW patients were somewhat older and more likely to live in relationships and have children, and they had higher incomes. Work participation, previous psychiatric hospitalization and present diagnosis contributed uniquely to an explanation of which patients were included in the respective clinics. The RTW clinic seems to reach its intended target group. Almost all of the patients in this group participated in the work arena, and their psychopathologies were clearly dominated by common mental disorders. Most RTW patients’ general practitioners had followed them fairly closely in the year before referral, suggesting previous attempts at treatment in primary care settings. Conclusions Relative to outpatients in a specialized mental health care setting, RTW patients had lower symptoms, but still in the same moderate range of severity. They suffered the same reduction in quality of life. Almost all of the RTW patients were diagnosed with illnesses that can be treated effectively, about half of them had recurring mental health problems and many of them had been treated in primary care settings before referral. These findings indicate that this group has significant health problems that can benefit from treatment in specialized health care settings.
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Affiliation(s)
- Mattias Victor
- Lovisenberg Hospital, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Bjørn Lau
- Lovisenberg Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Torleif Ruud
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Murcia López G, Delclós Clanchet J, Ubalde López M, Calvo Bonacho E, Benavides FG. Has the Spanish economic crisis affected the duration of sickness absence episodes? Soc Sci Med 2016; 160:29-34. [PMID: 27209364 DOI: 10.1016/j.socscimed.2016.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 05/01/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
Abstract
The global economic crisis has had particularly intense effects on the Spanish labor market. We investigated whether the duration of non-work related sickness absence (SA) episodes in salaried workers had experienced any changes before and after the crisis started. This was a repeated cross-sectional analysis conducted in a dynamic cohort in 2006 and 2010. Database was provided by eight mutual insurance companies, covering 983,108 workers and 451,801 SA episodes. Descriptive analysis and crude, bivariate and multivariate analyses using Cox proportional hazards modeling were performed, to quantify the changes in duration of SA episodes between 2006 and 2010, stratified by sex. There was a higher number of episodes in 2010 for both sexes, but especially for women. Unadjusted median duration in men was similar for both years, while for women it was shorter in 2010. Final multivariate models show a greater risk of longer episode duration for men in 2010 (HR 0.95; 95% CI, 0.95-0.95), but a shorter one for women (HR 1.07; 95% CI, 1.07-1.07). Once the economic crisis started affecting the Spanish labor market, the number of SA episodes in women equalized with those in men. There was a decrease of episodes in the youngest age groups, in the construction and in temporary contracts. The relative ranking of leading diagnoses was similar in both years with an increase in infectious, nervous system and respiratory diseases and in mental disorder episodes for both sexes, but especially for women. The risk of longer episode duration was greater in 2010 among men, but smaller in women.
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Affiliation(s)
- Guillermo Murcia López
- CISAL-Center for Research in Occupational Health, Universitat Pompeu-Fabra, Doctor Aiguader 88, 08003 Barcelona, Barcelona, Spain.
| | - Jordi Delclós Clanchet
- CISAL-Center for Research in Occupational Health, Universitat Pompeu-Fabra, Doctor Aiguader 88, 08003 Barcelona, Barcelona, Spain; CIBERESP, CIBER in Epidemiology and Public Health, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain; Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, P.O. Box 20186, Houston, TX 77225-0186, USA.
| | - Mònica Ubalde López
- CISAL-Center for Research in Occupational Health, Universitat Pompeu-Fabra, Doctor Aiguader 88, 08003 Barcelona, Barcelona, Spain; CIBERESP, CIBER in Epidemiology and Public Health, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain.
| | - Eva Calvo Bonacho
- Ibermutuamur, Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274, Calle Ramírez de Arellano, 27, 28043 Madrid, Spain.
| | - Fernando G Benavides
- CISAL-Center for Research in Occupational Health, Universitat Pompeu-Fabra, Doctor Aiguader 88, 08003 Barcelona, Barcelona, Spain; CIBERESP, CIBER in Epidemiology and Public Health, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain.
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Economic Evaluation of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Results of a Randomized Controlled Trial. J Occup Environ Med 2016; 57:666-75. [PMID: 25741795 DOI: 10.1097/jom.0000000000000423] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the cost-effectiveness of a Web-based guided intervention compared with care as usual for employees with depressive symptoms. METHODS A total of 231 employees with depressive symptoms were randomized. Data were collected at baseline, 8 weeks, 6 months, and 12 months. Analyses were conducted from the societal and employer's perspective. RESULTS At 12 months, a significant intervention effect on depressive symptoms was found. At a willingness to pay of 0 (€/unit of effect), the intervention's probabilities of cost-effectiveness were 0.62 (societal perspective) and 0.55 (employer's perspective). There was a 0.63 probability that the intervention resulted in a positive financial return for the employer. CONCLUSIONS The intervention's cost-effectiveness with regard to depressive symptoms depends on the willingness to pay of societal and company decision makers as well as the probability of cost-effectiveness that they consider acceptable. The intervention is not cost-saving to the employer.
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Shiels C, Gabbay M, Hillage J. Recurrence of sickness absence episodes certified by general practitioners in the UK. Eur J Gen Pract 2016; 22:83-90. [PMID: 27102090 DOI: 10.3109/13814788.2016.1156083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Compared to other areas of sickness certification, recurrence of certified sickness absence has been relatively under-researched. OBJECTIVES This study aims to report the extent and patterns of recurrence and to identify factors associated with higher rates of recurrence. METHODS Sickness certification ('fit note') data were collected from 68 general practices in eight regions of the UK for 12 months. RESULTS Twenty percent of 31,453 patients in the study had a recurrent certified sickness episode, with over half of these having the second episode in the same diagnostic category as their first. Mental health problems accounted for over a half of all days certified in same-diagnosis recurrent episodes. Male gender, residing in an area of social deprivation, a longer episode of initial certified sickness absence, not having return to work ('may be fit') advice in the first episode, having a mental disorder or musculoskeletal (particularly back) problem were all independently associated with a higher incidence of recurrence. CONCLUSION Differential risk of recurrence needs to be considered when designing return-to-work interventions. Evaluation of effectiveness of interventions (particularly for sickness absentees with mental health problems) has to consider the sustainability of employment after a return to work.
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Affiliation(s)
- Chris Shiels
- a Department of Health Services Research , University of Liverpool , UK
| | - Mark Gabbay
- a Department of Health Services Research , University of Liverpool , UK
| | - Jim Hillage
- b Institute for Employment Studies , Brighton , UK
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Sickness certification for common mental disorders and GP return-to-work advice. Prim Health Care Res Dev 2016; 17:437-47. [PMID: 26961125 DOI: 10.1017/s1463423616000074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
UNLABELLED Aim To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. BACKGROUND In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. METHODS Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for 'stress'. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any 'may be fit' advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive 'may be fit' advice on their CMD fit notes.
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Real E, Jover L, Verdaguer R, Griera A, Segalàs C, Alonso P, Contreras F, Arteman A, Menchón JM. Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis. PLoS One 2016; 11:e0146382. [PMID: 26730603 PMCID: PMC4701450 DOI: 10.1371/journal.pone.0146382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/16/2015] [Indexed: 02/02/2023] Open
Abstract
Background Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Methods Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008–2012. Results Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to ‘improvement’) and with working in the transport sector and public administration. Conclusions Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders.
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Affiliation(s)
- Eva Real
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- * E-mail:
| | - Lluís Jover
- Biostatistics Unit, Department of Public Health, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ricard Verdaguer
- Egarsat, Mutual Society for Work Accidents and Work-Related Illnesses n° 276, Spain
| | - Antoni Griera
- Egarsat, Mutual Society for Work Accidents and Work-Related Illnesses n° 276, Spain
| | - Cinto Segalàs
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Pino Alonso
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Antoni Arteman
- SSM–Serveis de Salut Mental S.L. Comprehensive Health Services for Sick Doctors, Galatea Foundation, Barcelona, Spain
| | - José M. Menchón
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Narusyte J, Björkenstam E, Alexanderson K, Ropponen A, Kjeldgård L, Svedberg P. Occurrence of sickness absence and disability pension in relation to childbirth: A 16-year follow-up study of 6323 Swedish twins. Scand J Public Health 2015; 44:98-105. [PMID: 26459495 DOI: 10.1177/1403494815610051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pregnancy, delivery, and the postpartum period may imply morbidity leading to work incapacity; however, this is seldom studied. This study aimed to compare twin sisters giving or not giving birth regarding occurrence of sickness absence (SA) and disability pension (DP). METHODS This population-based cohort study included all 6323 female twins born in Sweden 1959-1990, using register data for 1994-2010 about SA and DP. Average number of SA/DP days/year was calculated in relation to the year of the first delivery, or, if not giving birth, the year when the twin sister gave birth. Twin pairs discordant for delivery were used to investigate the importance of genetic and environmental factors for occurrence of SA and DP. RESULTS In all, 52% had a first delivery during 1994-2010. Except for the year of delivery, the average number of SA days/year was similar when comparing women who gave birth to those who did not, while number of DP days was significantly higher in women who did not give birth. Differences between the groups seem attributable to genetic factors. Women who delivered once had higher levels of SA and DP than those who had several deliveries. DP with mental diagnoses was more common among women who had not delivered whereas DP with musculoskeletal diagnoses occurred more often among women who delivered. CONCLUSIONS Levels of SA were similar among women who gave birth and who did not. Women not giving birth had significantly higher levels of DP, indicating health selections into childbirth.
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Affiliation(s)
- Jurgita Narusyte
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles, USA
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | | | - Linnea Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
| | - Pia Svedberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
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van Beurden KM, van der Klink JJL, Brouwers EPM, Joosen MCW, Mathijssen JJP, Terluin B, van Weeghel J. Effect of an intervention to enhance guideline adherence of occupational physicians on return-to-work self-efficacy in workers sick-listed with common mental disorders. BMC Public Health 2015; 15:796. [PMID: 26286039 PMCID: PMC4545325 DOI: 10.1186/s12889-015-2125-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/06/2015] [Indexed: 11/10/2022] Open
Abstract
Background Since a higher level of self-efficacy in common mental disorders is associated with earlier return-to-work (RTW), it is important to know if work related self-efficacy can be increased by occupational health care. The primary aim of this study was to evaluate whether an intervention to enhance guideline adherence of occupational physicians lead to an increase in RTW self-efficacy in workers three months later. The secondary aim was to evaluate whether the intervention modified the association between RTW self-efficacy and return-to-work three months later. Methods A total of 66 occupational physicians participated in the study. They were randomized into two groups; the intervention group received a training, the control group did not. The training aimed to enhance adherence to a mental health guideline that contained strategies that are supposed to enhance RTW self-efficacy. In 128 sick-listed workers guided by these occupational physicians, RTW self-efficacy, RTW, and personal, health-related and work-related variables were measured at baseline and three months later. Generalized linear mixed models analysis and linear mixed models analysis were used for the evaluations. Results In workers whose occupational physicians had received the training RTW self-efficacy increased significantly more than in workers whose occupational physicians had participated in the control group (t = −2.626, p ≤ .05). Higher baseline RTW self-efficacy scores were significantly more often associated with full RTW than with no RTW three months later (OR 2.20, 95 % CI 1.18–4.07), but the intervention did not affect this association. Conclusions This study showed that a training to enhance guideline adherence of occupational physicians leads to increased RTW self-efficacy in workers sick-listed with common mental disorders during the first months of sickness absence in a real-life occupational health care setting. This insight is helpful for optimizing the recovery and RTW process, and for understanding the role of RTW self-efficacy in this process. Trial registration ISRCTN86605310
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Affiliation(s)
- Karlijn M van Beurden
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000, LE, Tilburg, The Netherlands.
| | - Jac J L van der Klink
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000, LE, Tilburg, The Netherlands. .,Netherlands School of Public & Occupational Health, PO Box 20022, 3502, LA, Utrecht, The Netherlands.
| | - Evelien P M Brouwers
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000, LE, Tilburg, The Netherlands.
| | - Margot C W Joosen
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000, LE, Tilburg, The Netherlands.
| | - Jolanda J P Mathijssen
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000, LE, Tilburg, The Netherlands.
| | - Berend Terluin
- Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research, PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
| | - Jaap van Weeghel
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000, LE, Tilburg, The Netherlands. .,Phrenos Centre of Expertise, PO Box 1203, 3500, BE, Utrecht, The Netherlands. .,Parnassia Group, Dijk en Duin Mental Health Center, PO Box 305, 1900, AH, Castricum, The Netherlands.
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Norder G, Hoedeman R, de Bruin J, van Rhenen W, Roelen CAM. Time to recurrence of mental health-related absence from work. Occup Med (Lond) 2015; 65:574-7. [PMID: 26188192 DOI: 10.1093/occmed/kqv109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is unclear when occupational health providers should re-evaluate workers after mental health-related absences from work. AIMS To investigate the time to recurrence of mental health-related absences, stratified by International Classification of Diseases-Tenth Revision (ICD-10) diagnostic categories. METHODS A 10-year observational study of workers employed at a steel mill. Sickness absence data were retrieved from an occupational health register. Mental health-related absences were defined as absence due to emotional disturbance or mental and behavioural disorders. The first mental health-related absence since baseline was called the index episode. Recurrences were defined as mental health-related absences occurring >28 days after recovery from the index episode. The frequency of recurrent mental health-related absence was assessed by the recurrence density (RD) per 1000 person-years. The time to recurrent mental health-related absence was investigated by Kaplan-Meier survival analysis. RESULTS Of 15461 workers, 391 had recurrent mental health-related absences. RD was 30.5, 34.3, 29.9 and 37.7 per 1000 person-years after index episodes due to emotional disturbance, mood disorders, neurotic disorders and other psychiatric disorders, respectively. RDs did not differ across ICD-10 diagnostic categories. The median time to recurrent mental health-related absence was 15.2 months [95% confidence interval (CI) 12.6-17.7] and was shortest for mood disorders (5.2, 95% CI 1.4-8.9 months) and specific psychiatric disorders (5.3, 95% CI 1.0-13.1 months). CONCLUSIONS Based on this observational study, we suggest that occupational and primary health care providers consider reviewing the mental health status of workers 6 months after recovery from mental health-related absence.
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Affiliation(s)
- G Norder
- ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands, Department of Health Sciences, Division of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands,
| | - R Hoedeman
- ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands
| | - J de Bruin
- ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands
| | - W van Rhenen
- ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands, Center for Human Resource, Organization and Management Effectiveness, Business University Nyenrode, 3620 AC Breukelen, The Netherlands
| | - C A M Roelen
- ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands, Department of Health Sciences, Division of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands, Department of Epidemiology and Biostatistics, VU Medical Center, VU University, 1007 MB Amsterdam, The Netherlands
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Nexo MA, Borg V, Sejbaek CS, Carneiro IG, Hjarsbech PU, Rugulies R. Depressive symptoms and early retirement intentions among Danish eldercare workers: Cross-sectional and longitudinal analyses. BMC Public Health 2015; 15:677. [PMID: 26184519 PMCID: PMC4504417 DOI: 10.1186/s12889-015-1973-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/25/2015] [Indexed: 11/29/2022] Open
Abstract
Background Depression increases the risk of disability pension and represents a health related strain that pushes people out of the labour market. Although early voluntary retirement is an important alternative to disability pension, few studies have examined whether depressive symptoms incur early voluntary retirement. This study examined whether depressive symptoms and changes in depressive symptoms over time were associated with early retirement intentions. Methods We used a cross-sectional (n = 4041) and a prospective (n = 2444) population from a longitudinal study on employees of the Danish eldercare sector. Depressive symptoms were measured by the Major Depression Inventory and the impact of different levels of depressive symptoms (severe, moderately severe, moderate, mild and none) and changes in depressive symptoms (worsened, improved, unaffected) on early retirement intentions were analysed with multinomial logistic regression. Results In the cross-sectional analysis all levels of depressive symptoms were significantly associated with retirement intentions before the age of 62 years. Similar associations were found prospectively. Depressive symptoms and worsened depressive symptoms in the two year period from baseline to follow-up were also significantly associated with early retirement intentions before age 62. The prospective associations lost statistical significance when controlling for early retirement intentions at baseline. Conclusions The whole spectrum of depressive symptoms represents a health related strain that can incur intentions to retire early by early voluntary retirement. In order to change the intentions to retire early, the work related consequences of depressive symptoms should be addressed as early in the treatment process as possible.
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Affiliation(s)
- Mette Andersen Nexo
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark.
| | - Vilhelm Borg
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark.
| | - Camilla Sandal Sejbaek
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, Post box 2099, DK-1014, Copenhagen K, Denmark.
| | - Isabella Gomes Carneiro
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark. .,Cancer Research UK partnership with the National Cancer Intelligence Network, Wellington House, 133-55 Waterloo Road, London, SE1 8UG, U. K.
| | - Pernille U Hjarsbech
- Danish Institute for Local and Regional Government Research. Koebmagergade 22, DK-1150, Copenhagen K, Denmark.
| | - Reiner Rugulies
- The National Research Centre for the Working Environment, Lersoe Parkallé 105, DK-2100, Copenhagen, Denmark. .,Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, Post box 2099, DK-1014, Copenhagen K, Denmark. .,Department of Psychology, Copenhagen University, Oester Farigmagsgade 2A, DK-1353, Copenhagen, Denmark.
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Moving to Serene Nature May Prevent Poor Mental Health--Results from a Swedish Longitudinal Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7974-89. [PMID: 26184268 PMCID: PMC4515704 DOI: 10.3390/ijerph120707974] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 06/25/2015] [Accepted: 07/02/2015] [Indexed: 12/02/2022]
Abstract
Green spaces are recognized for improving mental health, but what particular kind of nature is required is yet not elucidated. This study explores the effect of specific types of recreational nature qualities on mental health. Longitudinal data (1999/2000 and 2005) from a public health survey was distributed to a stratified sample (n = 24,945) of a Swedish population. People from rural or suburban areas (n = 9230) who had moved between baseline and follow-up (n = 1419) were studied. Individual geographic residence codes were linked to five predefined nature qualities, classified in geographic information systems (GIS). Any change in the amount of or type of qualities within 300 m distance between baseline and follow-up was correlated to any change in mental health (as measured by the General Health Questionnaire) by logistic regression models. On average, the population had limited access to nature qualities both pre- and post-move. There was no significant correlation between change in the amount of qualities and change in mental health. However, the specific quality “serene” was a significant determinant with a significantly decreased risk for women of change to mental ill-health at follow-up. The objective definition of the potentially health-promoting quality may facilitate implication in landscape practice and healthy planning.
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Dellve L, Fallman SL, Ahlstrom L. Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home. Int Arch Occup Environ Health 2015; 89:171-9. [PMID: 26044671 DOI: 10.1007/s00420-015-1061-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave. METHODS A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work. RESULTS Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities. CONCLUSIONS This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.
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Affiliation(s)
- Lotta Dellve
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden. .,Ergonomics, School of Technology and Health, KTH - Royal Institute of Technology, Stockholm, Sweden.
| | - Sara L Fallman
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Linda Ahlstrom
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Baek JH, Kim YS, Yi KH. Relationship between Comorbid Health Problems and Musculoskeletal Disorders Resulting in Musculoskeletal Complaints and Musculoskeletal Sickness Absence among Employees in Korea. Saf Health Work 2015; 6:128-33. [PMID: 26106512 PMCID: PMC4476197 DOI: 10.1016/j.shaw.2015.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/16/2022] Open
Abstract
Background To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. Methods In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. Results The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2–6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6–11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. Conclusion Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered.
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Affiliation(s)
- Ji Hye Baek
- Occupational Health Team, Chungbuk Area Office, Korea Occupational Safety and Health Agency, Chungbuk, Korea
| | - Young Sun Kim
- Safety Management and Policy Research Department, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
| | - Kwan Hyung Yi
- Occupational Safety Research Department, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
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Gabbay M, Shiels C, Hillage J. Factors associated with the length of fit note-certified sickness episodes in the UK. Occup Environ Med 2015; 72:467-75. [DOI: 10.1136/oemed-2014-102307] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 11/04/2014] [Indexed: 11/04/2022]
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Health-related quality of life and productivity losses in patients with depression and anxiety disorders. J Occup Environ Med 2014; 56:420-4. [PMID: 24709765 DOI: 10.1097/jom.0000000000000112] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the explanatory power of disease severity and health-related quality of life (HRQOL) on absenteeism and presenteeism in a working population suffering from depression and/or anxiety disorders. METHODS We used data of a large, multicenter, randomized trial (n = 644). Pearson chi-squared tests, analysis of variance, and multinomial logistic regression analyses were performed to explore associations of the type of the disorder and HRQOL with different types of productivity losses. Multivariate regression analyses were performed to assess associations with the duration of absenteeism. RESULTS The type of the disorder, disease severity, and HRQOL were associated with different types of productivity losses. Health-related quality of life and age were significantly associated with the duration of absenteeism. CONCLUSIONS Our findings indicate that HRQOL may significantly explain the type of productivity loss as well as the duration of absenteeism.
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Eklund M. Anxiety, Depression, and Stress Among Women in Work Rehabilitation for Stress-Related Disorders. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2014. [DOI: 10.2753/imh0020-7411420402] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Mona Eklund
- a Department of Health Sciences, Occupational Therapy, and Occupational Science, Sweden
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Eklund M, Bäckström M, Tuvesson H. Psychometric properties and factor structure of the Swedish version of the Perceived Stress Scale. Nord J Psychiatry 2014; 68:494-9. [PMID: 24460116 DOI: 10.3109/08039488.2013.877072] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Perceived Stress Scale (PSS) measures general stress and the Swedish version, although used in several studies, has not been extensively evaluated for psychometric properties. AIMS This study aimed to investigate psychometric properties and the factor solution of the Swedish 14-item version when used with two samples, namely a mixed Internet sample of women and men (n = 171) and another of women with stress-related disorders (n = 84). Classical test theory, including confirmatory factor analysis, was employed. RESULTS The factor structure supported a two-factor model for the PSS and confirmed other language versions of the PSS, although one items showed a low item-total correlation. The PSS showed to be feasible with the investigated samples and the results indicated no ceiling or floor effects and good internal consistency of the PSS. Several aspects of construct validity were shown. An association of - 0.66 between the PSS and a measure of coping indicated good concurrent validity. Criterion validity was demonstrated through a statistically significant difference (P < 0.001) between the women with stress-related disorders and the Internet sample. Predictive validity of the PSS could be demonstrated in a short-term perspective. Based on the sample with stress-related disorders, sensitivity to change was shown through a statistically significant stress reduction (P < 0.001) from entering work rehabilitation to discharge. CONCLUSIONS The Swedish version of the PSS showed satisfactory psychometric properties and may be recommended for use with people with and without known stress-related disorders.
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Affiliation(s)
- Mona Eklund
- Mona Eklund, Ph.D., Professor, Department of Health Sciences, Lund University , Lund , Sweden
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Roelen CAM, Heymans MW, van Rhenen W, Groothoff JW, Twisk JWR, Bültmann U. Fatigue as prognostic risk marker of mental sickness absence in white collar employees. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:307-315. [PMID: 23821309 DOI: 10.1007/s10926-013-9458-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To investigate fatigue as prognostic risk marker for identifying working employees at risk of long-term sickness absence (SA). METHODS At baseline, fatigue was measured in 633 white collar employees with the checklist individual strength (CIS) including scales for fatigue severity, reduced concentration, reduced motivation, and reduced physical activity. SA was medically certified by an occupational physician in the 3rd or 4th SA week with diagnostic codes according to the 10th version of the International Classification of Diseases. Medically certified SA was retrieved at the individual level from an occupational health register after 1-year follow-up. CIS scores were investigated as prognostic risk markers predicting medically certified SA and particularly SA certified as mental SA. RESULTS 614 employees (N = 378 men and N = 236 women) had complete data and were eligible for analysis; 63 (10 %) had medically certified SA of whom 39 (6 %) had mental SA. Fatigue severity and total CIS scores were associated with medically certified SA in men, but poorly discriminated between men with and without medically certified SA. Fatigue severity, reduced concentration, reduced motivation, and total CIS scores were also associated with mental SA in men. CIS and its reduced concentration scale were valid prognostic risk markers of mental SA. CONCLUSION Fatigue was a prognostic risk marker of mental SA in white collar men. The CIS should be further validated as a screening tool for the risk of mental SA in white collar working populations.
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Affiliation(s)
- C A M Roelen
- Department of Health Sciences, Methodology and Applied Biostatistics, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands,
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Welsh VK, Sanders T, Richardson JC, Wynne-Jones G, Jinks C, Mallen CD. Extending the authority for sickness certification beyond the medical profession: the importance of 'boundary work'. BMC FAMILY PRACTICE 2014; 15:100. [PMID: 24884678 PMCID: PMC4030269 DOI: 10.1186/1471-2296-15-100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 05/13/2014] [Indexed: 11/19/2022]
Abstract
Background The study aimed to explore the views of general practitioners (GPs), nurses and physiotherapists towards extending the role of sickness certification beyond the medical profession in primary care. Methods Fifteen GPs, seven nurses and six physiotherapists were selected to achieve varied respondent characteristics including sex, geographical location, service duration and post-graduate specialist training. Constant-comparative qualitative analysis of data from 28 semi-structured telephone interviews was undertaken. Results The majority of respondents supported the extended role concept; however members of each professional group also rejected the notion. Respondents employed four different legitimacy claims to justify their views and define their occupational boundaries in relation to sickness certification practice. Condition-specific legitimacy, the ability to adopt a holistic approach to sickness certification, system efficiency and control-related arguments were used to different degrees by each occupation. Practical suggestions for the extension of the sickness certification role beyond the medical profession are underpinned by the sociological theory of professional identity. Conclusions Extending the authority to certify sickness absence beyond the medical profession is not simply a matter of addressing practical and organisational obstacles. There is also a need to consider the impact on, and preferences of, the specific occupations and their respective boundary claims. This paper explores the implications of extending the sick certification role beyond general practice. We conclude that the main policy challenge of such a move is to a) persuade GPs to relinquish this role (or to share it with other professions), and b) to understand the ‘boundary work’ involved.
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Affiliation(s)
| | - Tom Sanders
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK.
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Løvvik C, Øverland S, Hysing M, Broadbent E, Reme SE. Association between illness perceptions and return-to-work expectations in workers with common mental health symptoms. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:160-70. [PMID: 23595310 DOI: 10.1007/s10926-013-9439-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE Mental health symptoms (MHSs) may affect people's work capacity and lead to sickness absence and disability. Expectations and perceptions of illness have been shown to influence return to work (RTW) across health conditions, but we know little about illness perceptions and RTW-expectations in MHSs. The aim of this study was to investigate the association between illness perceptions and RTW-expectations in a group struggling with work participation due to MHSs. METHODS Cross-sectional associations between illness perceptions and return to work expectations at baseline were analyzed for 1,193 participants who reported that MHSs affected their work participation. The study was part of a randomized controlled trial evaluating the effect of job focused Cognitive Behavioral Therapy (CBT) combined with supported employment (IPS). Participants were from a working age population with diverse job status. RESULTS There was a strong and salient relationship between illness perceptions and RTW-expectations. When adjusting for demographic and clinical variables, the components consequences, personal control, identity and illness concern remained significantly associated with uncertain and negative RTW-expectations. Less illness understanding remained significantly associated with uncertain RTW-expectations, while timeline and emotional representations remained significantly associated with negative RTW-expectations. In the fully adjusted model only the consequences component (believing that illness has more severe consequences) remained significantly associated with RTW-expectations. Openly asked, participants reported work, personal relationships and stress as main causes of their illness. CONCLUSIONS In people with MHSs who struggle with work participation, perceptions and beliefs about their problems are strongly associated with their expectations to return to work.
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Affiliation(s)
- Camilla Løvvik
- Uni Health, Uni Research, Krinkelkroken 1, 5015, Bergen, Norway,
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van Berkel J, Boot CRL, Proper KI, Bongers PM, van der Beek AJ. Effectiveness of a worksite mindfulness-related multi-component health promotion intervention on work engagement and mental health: results of a randomized controlled trial. PLoS One 2014; 9:e84118. [PMID: 24489648 PMCID: PMC3904825 DOI: 10.1371/journal.pone.0084118] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 11/11/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate the effectiveness of a worksite mindfulness-related multi-component health promotion intervention on work engagement, mental health, need for recovery and mindfulness. METHODS In a randomized controlled trial design, 257 workers of two research institutes participated. The intervention group (n = 129) received a targeted mindfulness-related training, followed by e-coaching. The total duration of the intervention was 6 months. Data on work engagement, mental health, need for recovery and mindfulness were collected using questionnaires at baseline and after 6 and 12 months follow-up. Effects were analyzed using linear mixed effect models. RESULTS There were no significant differences in work engagement, mental health, need for recovery and mindfulness between the intervention and control group after either 6- or 12-months follow-up. Additional analyses in mindfulness-related training compliance subgroups (high and low compliance versus the control group as a reference) and subgroups based on baseline work engagement scores showed no significant differences either. CONCLUSIONS This study did not show an effect of this worksite mindfulness-related multi-component health promotion intervention on work engagement, mental health, need for recovery and mindfulness after 6 and 12 months. TRIAL REGISTRATION Netherlands Trial Register NTR2199.
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Affiliation(s)
- Jantien van Berkel
- Department of Public and Occupational Health - EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Cécile R. L. Boot
- Department of Public and Occupational Health - EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Karin I. Proper
- Department of Public and Occupational Health - EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Paulien M. Bongers
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, the Netherlands
- Department of Work and Employment, TNO Quality of Life, Hoofddorp, the Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health - EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, the Netherlands
- * E-mail:
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Personality disorders and long-term sick leave: a population-based study of young adult Norwegian twins. Twin Res Hum Genet 2014; 17:1-9. [PMID: 24417773 DOI: 10.1017/thg.2013.90] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Personality disorders (PDs) reduce global functioning, are associated with high levels of work disability, and are thus also likely to influence long-term sick leave (LTSL). Previous research has indicated significant genetic influence on both DSM-IV PDs and LTSL. To what degree genes contributing to PDs also influence LTSL has not been investigated. The aims of the current study were to investigate which PDs were significantly associated with LTSL, to what extent the genetic contributions to these PDs account for the heritability of LTSL, and to explore the hypothesis of a causal association between PDs and LTSL. The sample consisted of 2,771 young, adult Norwegian twins, born 1967-1979. PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV). The age range for the interview was 20-32. The data were subsequently linked to public records of LTSL (sick leave >16 days) up to 11 years later. The odds ratio for being in the highest LTSL category (>15% sick leave) when fulfilling the DSM-IV criteria for any PD diagnosis was 2.6 (1.8-3.8, 95% CI). Dimensional representations of schizotypal, paranoid, and borderline PD were independently and significantly associated with LTSL. The heritability of LTSL was 0.50. Genetic factors shared with the PDs accounted for 20% of this. The association between PDs and LTSL was due to shared genetic and not environmental influences, and was mainly explained by one common genetic factor. The hypothesis of a causal association was not supported, indicating that the association is explained by overlapping genetic liability between PDs and LTSL.
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Ikeda E, Shiozaki K, Ikeda H, Suzuki M, Hirayasu Y. Prefrontal dysfunction in remitted depression at work reinstatement using near-infrared spectroscopy. Psychiatry Res 2013; 214:254-9. [PMID: 24139959 DOI: 10.1016/j.pscychresns.2013.07.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 07/14/2013] [Accepted: 07/25/2013] [Indexed: 01/27/2023]
Abstract
A long-term and/or recurrent sickness absence from work due to depression has been an important health problem in industrial countries. In addition, previous sick leave is a risk factor of recurrence. However, many characteristics, especially biological aspects, have not been investigated in remitted depressive patients who were ready to return to work from sickness absence. Therefore, the purpose of this study is to clarify the pathophysiological characteristics of patients who were at risk for recurrence of sickness absence. We recruited 21 patients and 16 healthy control subjects. All patients were ready to return to work within one month from long-term sickness absence. All subjects were examined for prefrontal function represented by oxyHb changes during the verbal fluency task (VFT) and the Stroop task using near-infrared spectroscopy. Suppressed prefrontal reaction during the VFT and increased prefrontal reaction during the Stroop task were observed in the patient group compared with the control group. Significantly lengthened reaction time was observed in the incongruent condition in the patient group during the Stroop task. Depressive patients showed impaired executive function measured by the Stroop task and had prefrontal dysfunction despite clinical remission. Residual prefrontal dysfunction may be one biological reason for repetitive sickness absence.
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Affiliation(s)
- Eiji Ikeda
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan; Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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Nordenskjöld A, von Knorring L, Brus O, Engström I. Predictors of regained occupational functioning after electroconvulsive therapy (ECT) in patients with major depressive disorder--a population based cohort study. Nord J Psychiatry 2013; 67:326-33. [PMID: 23228156 DOI: 10.3109/08039488.2012.745602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS The aim of the present study is to investigate the rate of regained occupational functioning among patients treated with electroconvulsive therapy (ECT) for major depression and to define predictors of time to regained occupational functioning. METHODS A nested cohort study was performed of patients treated by ECT for unipolar major depressive disorder registered in the Quality register for ECT and in the Swedish Social Insurance Agency registry. Predictive values of single clinical variables and their relative importance were tested with Cox regression analysis. RESULTS 394 patients were identified. Of those, 266 were on non-permanent sick leave and 128 on disability pension during ECT. Within 1 year post-ECT, 71% of the patients with non-permanent sick leave regained occupational functioning. Factors independently associated with a statistically significant increased time to regained occupational functioning were longer duration of sick leave pre-ECT, milder depression pre-ECT, less complete improvement with ECT, benzodiazepine treatment after ECT and co-morbid substance dependence. CONCLUSIONS A large proportion of the patients do not return to work within several months post-ECT. Paradoxically, patients with more severe depression pre-ECT had a reduced time to regained occupational functioning, indicating a larger effect in this patients group of the treatment. Moreover, the period with sick leave compensation might be reduced if ECT is initiated within the first 3 months of sick leave. CLINICAL IMPLICATIONS Most patients on non-permanent sick leave regain occupational functioning after ECT. However, it usually takes a few months even in symptomatically improved patients.
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Affiliation(s)
- Axel Nordenskjöld
- Psychiatric Research Centre, Örebro County Council, Örebro, Sweden; School of Health and Medical Sciences, Örebro University , Örebro , Sweden
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Those Who Hesitate Are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part I. PSYCHOLOGICAL INJURY & LAW 2013. [DOI: 10.1007/s12207-013-9163-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Warren PA. Those Who Hesitate are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part II. PSYCHOLOGICAL INJURY & LAW 2013. [DOI: 10.1007/s12207-013-9164-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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van Berkel J, Proper KI, van Dam A, Boot CRL, Bongers PM, van der Beek AJ. An exploratory study of associations of physical activity with mental health and work engagement. BMC Public Health 2013; 13:558. [PMID: 23758966 PMCID: PMC3682939 DOI: 10.1186/1471-2458-13-558] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 05/30/2013] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies have found moderate to vigorous physical activity (MVPA) to be associated with a decreased risk of mental disorders. Although the focus in the field of psychology has shifted towards human strengths and optimal functioning, studies examining associations between MVPA and mental health in general (MH) and between MVPA and well-being are scarce. An indicator of work-related well-being is work engagement (WE). The aim of this study was to explore the associations between MVPA and MH, and between MVPA and WE. Methods In this study, a total of 257 employees from two research institutes, self-reported their MVPA, MH and level of WE. In addition, a randomly chosen subgroup (n=100) wore an Actigraph accelerometer for a 1-week period to measure their MVPA objectively. Crude and adjusted associations between MVPA and both WE and MH were analyzed using linear regression analyses. Results There was no statistically significant association between self-reported MVPA and mental health, resulting from both the crude (b=0.058, 95% CI -0.118 - 0.235) and adjusted analyses (b=0.026; 95% CI -0.158- 0.210), nor between objectively measured MVPA and mental health for both crude and adjusted analyses (b=-0.144; 95% CI -1.315- 1.027; b=-0.199; 95% CI 1.417- 1.018 respectively). There was also no significant association between self-reported MVPA and work engagement (crude: b=0.005; 95% CI -0.005-0.016, adjusted: b= 0.002; 95% CI -0.010- 0.013), nor between objectively measured MVPA and work engagement (crude: b= 0.012; 95% CI -0.084- 0.060, adjusted: b=0.007; 95% CI -0.083-0.069). Conclusions Although the beneficial effects of MVPA on the negative side of MH (i.e. mental disorders) have been established in previous studies, this study found no evidence for the beneficial effects of MVPA on positive side of MH (i.e. well-being). The possible difference in how the physical activity-mental health relationship works for negative and positive sides of MH should be considered in future studies.
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Affiliation(s)
- Jantien van Berkel
- Department of Public and Occupational Health - EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands
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Genetic susceptibility to sickness absence is similar among women and men: findings from a Swedish twin cohort. Twin Res Hum Genet 2013; 15:642-8. [PMID: 22931554 DOI: 10.1017/thg.2012.47] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Previous studies of risk factors for sickness absence (SA) focus primarily on psychosocial and work environmental exposures. The aim of this study was to investigate the relative contribution of genetic influences on SA among women and men. The population-based study sample of Swedish twins (34,547) included 13,743 twin pairs of known zygosity, 3,495 monozygotic, 5,073 same-sexed dizygotic, and 5,175 opposite sexed. The point prevalence of long-term SA (≥15 days) in each zygosity and sex group was calculated. The risk of SA was estimated as an odds ratio (OR) with 95% confidence intervals (CI) where the odds for twins on SA to have a co-twin on SA was compared to the OR for SA in twins whose co-twin were not sickness absent. Intrapair correlations and probandwise concordance rates were calculated and standard biometrical genetic model-fitting methods were used to estimate the heritability of SA. The prevalence of SA was 8.8% (women 10.7%; men 6.5%). Intrapair similarity was higher among monozygotic than dizygotic twin pairs. The best-fitting model showed no sex differences in genetic effects or variance components contributing to SA. The heritability estimate was 36% (95% CI: 35-40%). Results suggest genetic contribution to the variation of SA and that environmental factors have an important role, for women and men. As SA seem to be influenced by genetic factors, future studies of associations between risk factors and SA should consider this potentially confounding effect.
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Knudsen AK, Harvey SB, Mykletun A, Øverland S. Common mental disorders and long-term sickness absence in a general working population. The Hordaland Health Study. Acta Psychiatr Scand 2013; 127:287-97. [PMID: 22775341 DOI: 10.1111/j.1600-0447.2012.01902.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine and compare the prospective effect of the common mental disorders (CMD) anxiety and depression on duration and recurrence of sickness absence (SA), and to investigate whether the effect of CMD on SA is detectable over time. METHOD Information from a large epidemiological health study (N = 13 436) was linked with official records of SA episodes lasting ≥16 days up to 6 years after participation. Common mental disorders were assessed with the Hospital Anxiety and Depression Scale (HADS). Associations were analysed with Cox regression and multinomial logistic regression models controlling for potential covariates. RESULTS Comorbid anxiety and depression, and anxiety only were significant risk factors for SA after adjusting for covariates, whilst depression only was not. Anxiety and depression were stronger predictors for longer duration of SA episodes compared with shorter duration and associated with more frequent recurrence of SA. There was a general trend toward the effect of CMD on SA becoming weaker over time; however, the effect of anxiety only on SA remained stable throughout the follow-up. CONCLUSION Common mental disorders are long-lasting predictors of onset, duration and recurrence of SA. Anxiety appears to be a more important contributor to long-term SA than previously described in the literature.
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Affiliation(s)
- A K Knudsen
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Norway.
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