Depression symptoms and risk of sick leave: a systematic review and meta-analysis

Working life patterns after sickness absence due to depression: A 15-year register-based prospective cohort study

AIM

To identify working life patterns after sickness absence (SA) due to depression and sociodemographic, work, and health-related factors associated with them.

METHODS

The study cohort included 9139 Swedish residents, aged 25-40, with a new SA spell due to depression in 2005. We followed the cohort for 15 years analyzing their yearly dominant labor market outcomes. Sequence analysis was used to identify distinct labor market sequences and cluster analysis - to group similar sequences into working life typologies. For the sociodemographic, work, and health-related factor analysis, we used multinomial logistic regression.

RESULTS

We identified 4373 sequences and seven typologies: 1) "Predominant Economic Activity (EA)" (70.7 %), 2) "Predominant EA with Intermittent SA/Disability Pension (DP)" (14.4 %), 3) "Predominant Long-Term SA/DP" (8.0 %), 4) "Long-Term SA/DP Followed by No EA" (2.2 %), 5) "SA/DP with Some EA" (1.6 %), 6) "Emigration" (1.7 %), and 7) "Death" (1.4 %). Factors associated with the predominant long-term SA/DP typology included birth outside Sweden (OR = 1.61, 95 % CI: 1.29-2.01), lower educational attainment (OR = 3.20, 95 % CI: 2.42-4.22), prolonged index SA spell due to depression (OR = 4.81, 95 % CI: 3.71-6.25), prior long-term SA (OR = 3.60, 95 % CI: 2.87-4.50) and unemployment (OR = 2.00, 95 % CI: 1.61-2.48). Living with children (OR = 0.68, 95 % CI: 0.56-0.82) was associated with lower odds of belonging to this typology.

CONCLUSIONS

Most individuals after SA due to depression maintained their engagement in the labor market suggesting that Sweden's welfare system is supportive of their workforce participation. However, some individuals belonged to long-term SA, DP, and lack of EA typologies indicating a potential path to labor market marginalization.

Association between plant-based diets and depressive symptoms among Chinese middle-aged and older adults

This study aimed to evaluate associations between plant-based diets and the prevalence of depressive symptoms (DepS) among Chinese middle-aged and older adults. This study included 3153 participants aged 45 and older. Dietary intake was collected using a food frequency questionnaire, and DepS was evaluated using the 9-item Patient Health Questionnaire. Foods were classified into 17 groups and three plant-based diet indices were created, including the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Compared to the lowest quartile, participants in the highest quartile of hPDI had lower odds of DepS (OR = 0.60; 95% CI: 0.40, 0.89). Conversely, the highest quartile of the uPDI was associated with higher odds of DepS (OR = 1.81; 95% CI: 1.16, 2.82). These findings supported that the quality of plant-based diets matters for mental health.

Depression care trajectories and sustainable return to work among long-term sick-listed workers: a register-based study (The Norwegian GP-DEP Study)

BACKGROUND

Depressive disorders can negatively impact work life sustainability for affected individuals. Little is known about depression care trajectories and their association with sustainable return to work (SRTW) after long-term sick leave. This study aimed to identify depression care trajectories during the first three months of sick leave among long-term sick-listed workers with depression and investigate their associations with SRTW.

METHODS

DESIGN: Nationwide cohort study using linked data from Norwegian health and population registries.

STUDY POPULATION

All inhabitants of Norway aged 20-64 from 1 January 2009 to 1 April 2011, who were diagnosed with depression in general practice, and had reached three months consecutive sick leave (n = 13 624, 63.7% women).

EXPOSURE

Depression care trajectories during the first three months of initial sick leave, identified using group-based multi-trajectory modeling. Types of depression care included were general practitioner (GP) consults, GP longer consults and/or talking therapy, antidepressant medication (MED), and specialized mental healthcare.

OUTCOME

SRTW, measured by accumulated all-cause sickness absence days during two-year follow-up after initial sick leave, with cutoffs at 0, ≤ 30, and ≤ 90 days.

ANALYSIS

Gender stratified generalized linear models, used to investigate the associations between depression care trajectories and SRTW, adjusting for sociodemographic factors and sick leave duration.

RESULTS

Four depression care trajectory groups were identified: "GP 12 weeks" (37.2%), "GP 2 weeks" (18.6%), "GP & MED 12 weeks" (40.0%), and "Specialist, GP & MED 12 weeks" (8.7%). The "GP 12 weeks" group (reference) had the highest proportion attaining SRTW for both genders. Men in the "GP 2 weeks" group had a 12-14% lower likelihood for SRTW compared to the reference. Women in the "Specialist,GP & MED 12 weeks 12 weeks" group had a 19- 23% lower likelihood for SRTW compared to the reference.

CONCLUSION

The association between depression care trajectories and SRTW varies by gender. However, trajectories involving follow-up by the GP, including both standard and longer consults and/or talking therapy over 12 weeks, showed the highest likelihood of SRTW for both genders. Enhancing GP resources could improve SRTW outcomes by allowing more frequent and longer consultations or talking therapy.

Gender differences in psychosomatic complaints across occupations and time from 2006 to 2018 in Germany: a repeated cross-sectional study

BACKGROUND

Previous research indicates that women report more psychosomatic complaints at work compared to men. However, there is a lack of research examining this gender gap across different occupational subgroups and over time.

METHODS

The study utilized data from the nationwide German Employment Survey of the Working Population on Qualification and Working Conditions conducted in 2005/2006, 2011/2012, and 2017/ 2018. First, gender differences in psychosomatic complaints were analysed within the occupational subgroups categorized as white-collar high-skilled, white-collar low-skilled, blue-collar high-skilled and blue-collar low-skilled workers. Second, gender stratified time trends of psychosomatic complaints were analysed. A total of 58,759 participants were included in the analysis.

RESULTS

Women consistently reported significantly higher levels of psychosomatic complaints compared to men across all years examined. The largest differences were observed in white-collar high-skilled occupations. From 2005/2006 to 2011/2012, gender differences increased; from 2011/2012 to 2017/2018, they stagnated.

CONCLUSIONS

The study revealed that women experience more psychosomatic distress at work than men in all occupational subgroups and time points. White-collar high-skilled workers showed the highest gender gap in psychosomatic complaints. The gender gap widened from 2005/2006 to 2011/2012 and remained stable from 2011/2012 to 2017/2018. Future research should investigate the reasons and implications of this phenomenon, especially considering the increasing proportion of high-skilled white-collar workers, where the gender gap is most evident.

A study on the identification of factors related to depression in a population with an increasing number of chronic diseases in the short term in China based on a health ecology model

BACKGROUND

The rapid increase in the number of patients with chronic diseases and depression, as well as the rapid spread of their effects, have led to these two health problems gradually developing into major public health issues in China and around the world. Currently, many individuals with chronic diseases are experiencing depressive symptoms one after another. Therefore, it is imperative to conduct research on how to prevent depression in this growing population of individuals with chronic diseases in a timely manner.

METHODS

Based on the data of the 2015 and 2018 national follow-up surveys of the China Health and Retirement Longitudinal Study, a total of 7641 patients with short-term increase in the number of chronic diseases were selected as the study objects, and a binary logistic regression model was constructed according to the five dimensions of the health ecology model. The neural network model was used to explore the main (first two) factors affecting the increase in the number of chronic diseases in China in the short term, and the random forest and extreme value gradient lifting algorithm were used to verify them, and effective suggestions were put forward.

RESULTS

The detection rate of depression in the population with increasing number of chronic diseases from 2015 to 2018 was 42.13 %. The model was established based on five dimensions of the health ecology model: Model 1 (Personal trait layer), Model 2 (Personal trait layer plus Behavioral feature layer), Model 3 (Personal trait layer plus Behavioral feature layer plus Living and working conditions layer), Model 4 (Personal trait layer plus Behavioral feature layer plus Living and working conditions layer plus Networking layer) and Model 5 (Personal trait layer plus Behavioral feature layer plus Living and working conditions layer plus Networking layer plus Policy environment layer).The prediction accuracy of the five models was 66.4 %, 68.3 %, 70.7 %, 71.6 % and 71.6 %, respectively, and Model 5 showed that the P values of gender, self-rated health, night's sleep time (h), disability, life satisfaction, child satisfaction, place of residence and highest level of education were all <0.05, life satisfaction and self-rated health importance were 0.249 (100 %) and 0.226 (90.8 %).

CONCLUSION

Gender, self-rated health, night sleep duration, disability, satisfaction with life, satisfaction with children, place of residence and highest level of education were the main influencing factors for the increase of depressive symptoms in the population with chronic diseases in the short term, among which life satisfaction and self-rated health have the greatest impact on depressive symptoms, and there is an interaction between the two.

General practitioners' attitudes and practices regarding sick leave certification for patients with depression in Norway - a cross-sectional study

BACKGROUND

Depression is among the most frequent reasons for sick leave, whereas health authorities recommend a rather strict practice, arguing that work is health-promoting. We aimed to explore GPs' attitudes and practices regarding sick leave certification for depressed patients.

METHODS

A cross-sectional study using the Norwegian Physician Survey (N = 1617, 70% response rate) in 2021. The GPs in the panel (N = 221) responded to questions about sick leave certification and cooperation with employers and the Norwegian Labour and Welfare Administration (Norwegian acronym: Nav) regarding patients with depression. We used crosstabulation with chi square statistics and logistic regression models to assess differences among GPs.

RESULTS

Among 221 GPs, 62% often/very often perceived patients' questions for sick leave certification as the main reason for encountering. A total of 46% often/very often considered patients' expectations inappropriate, with female GPs more frequently than male GPs (36% vs 56%, p = 0.005) and younger GPs more frequently than their older counterparts (p < 0.001). Although 68% considered sick leave as part of treatment, only 16% often/very often initiated sick leave unless patients raised the question. Sixty-seven percent of GPs reported to often/very often avoid sick listing, if possible, more females than males. GPs who often/very often considered questions for sick leave inappropriate less often considered sick leave as part of treatment (odds ratio (OR): 0.25; 95% CI: 0.13-0.49), and less often report a well-functioning cooperation with Nav (OR:0.37; 95% CI:0.14-0.96). GPs who often/very often considered sick leave as part of treatment more often proposed sick leave for their patients (OR:4.70; 96% CI 1.57-14.01) and reported a less strict approach to sick listing (OR: 40; 95% CI: 0.20-0.79). Ninety-five percent of the GPs rarely/never had direct contact with patients' employers, whereas 92% often/very often asked patients about their dialogue with the workplace. Eighty-eight percent of the GPs often/very often experienced cooperation with NAV as good, and 87% often/very often felt trusted by them.

CONCLUSIONS

Most GPs reported a strict attitude towards sick leave for depression, whereas one-third had a less strict approach. Different perceptions of the appropriateness of sick listing indicate variations in treatment and access to social security benefits.

Psychological problems among elementary and high school educators in Canada: association with sick days in the prior school year

Background

Increased sick leave among educators can detrimentally impact students' productivity, and academic achievement. It remains unknown whether the number of sick days taken by educators in the preceding school year correlates with the prevalence or severity of psychological problems among educators in the subsequent school year.

Objective

This study aimed to examine the number of self-reported sick days taken by educators in three Canadian provinces during the 2021/2022 academic year and its association with measures of stress, burnout, low resilience, depression, and anxiety during the 2022/2023 school year.

Methods

Data was collected from educators in three Canadian provinces, Alberta, Nova Scotia, and Newfoundland and Labrador, from September 1, 2022, to August 30, 2023. The Maslach Burnout Inventory-Educator Survey (MBI-ES), the Brief Resilience Scale (BRS), and the Perceived Stress Scale were used to assess burnout, resilience, and stress, respectively. Likely Generalized Anxiety Disorder (GAD) and likely Major Depressive Disorder (MDD) were assessed using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scales, respectively. Statistical analysis was conducted using SPSS version 28.

Results

A total of 763 subscribers completed all the demographic, professional questions, and clinical scales, giving a response rate of 39.91%. Of these, there were 94 (12.3%) males and 669 (87.7%) females. Educators who reported taking 11 or more sick days in the previous academic year were at least three times more likely to exhibit high stress, emotional exhaustion, likely GAD, low resilience, and likely MDD than educators with no sick days during the preceding year. Similarly, educators with 11 or more sick days had significantly higher mean scores on the GAD-7 scale, the PHQ-9 scale, the PSS-10, the MBI Emotional Exhaustion subscale, and the MBI Depersonalization subscale than those with zero sick days.

Conclusion

This study demonstrates a significant association between sick days and the prevalence and severity of high stress, low resilience, burnout, anxiety, and depression among educators. Short-term sick leave can escalate into long-term absences without adequate support for teachers. Governments and policymakers in the education sector must foster a supportive environment that enables teachers to thrive and effectively perform their professional role without taking prolonged sick days, which can undermine student learning and achievement.

Gender inequalities of psychosomatic complaints at work vary by occupational groups of white- and blue-collar and level of skill: A cross sectional study

BACKGROUND

Previous research has shown that women report more psychosomatic complaints at work than men. However, knowledge about gender inequalities in psychosomatic complaints within occupational groups and specific symptoms is lacking. This study aims to compare gender inequalities in psychosomatic complaints in the occupational groups of white-collar high-skilled, white-collar low-skilled, blue-collar high-skilled and blue-collar low-skilled workers.

METHODS

The study implemented a cross sectional design using data from the nationwide German Employment Survey of the Working Population on Qualification and Working Conditions conducted in 2017/ 2018. Psychosomatic complaints were operationalised by the following symptoms: headache, insomnia, tiredness, irritability, dejection, physical fatigue, and emotional fatigue. N = 20012 working German-speaking respondents were sampled. After excluding persons with missing data on the study variables, the sample consisted of N = 16359 persons.

RESULTS

Women reported significantly more psychosomatic complaints than men in the subgroups of white-collar high-skilled and white-collar low-skilled (ps < .05), inequalities in blue-collar high-skilled and blue-collar low-skilled only being numerical. Regarding specific symptoms, women reported more psychosomatic complaints then men in the subgroups of white-collar high-skilled workers, white-collar low-skilled workers, and blue-collar low-skilled workers. Headaches, physical fatigue, and emotional fatigue were the most common symptoms. The white-collar high-skilled subgroup had the highest number of symptoms with significant gender inequalities. These effects remained after controlling for age, working hours, parental status and marital status.

CONCLUSIONS

Gender inequalities in psychosomatic complaints are ubiquitous but vary in their frequency by occupational subgroup and specific psychosomatic complaint. Women in white-collar high-skilled jobs in particular report to be burdened more often by many specific psychosomatic symptoms. Future studies should investigate the reasons for these occupational inequalities and develop interventions to reduce health inequalities in the workplace.

Factors Related to the Recurrence of Sickness Absence Due to Common Mental Health Disorders: A Systematic Review

PURPOSE

Employees who experience sickness absence (SA) due to common mental disorders (CMD) are at increased risk of recurrent sickness absence (RSA). This systematic literature review examines the factors at different levels in the work and non-work context that increase or decrease the likelihood of RSA due to CMD. The resulting knowledge enables more accurate identification of employees at risk of RSA.

METHODS

We conducted a search in June 2023 using the following databases: PubMed, PsycInfo, Web of Science, Cumulative Index to Nursing & Allied Health Literature (Cinahl), Embase and Business Source Ultimate (BSU). Inclusion criteria were as follows: (self-)employees, CMD, related factors, RSA. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Individual, Group, Leader, Organisation and Overarching/social context (IGLOO) model were used to cluster the found factors and these factors were graded by evidence grading.

RESULTS

Nineteen quantitative and one qualitative studies of mainly high and some moderate quality were included in this review. A total of 78 factors were found. These factors were grouped according to the IGLOO levels and merged in 17 key factors. After evidence grading, we found that mainly low socioeconomic status (SES) and the type of previous SA (short-term SA and SA due to CMD) are predictors of an increased risk of RSA.

CONCLUSIONS

Having a low SES and previous experience of SA (short term, or due to CMD) are factors that predict the chance of RSA, implying the need for prolonged support from occupational health professionals after the employee has returned to work.

Effect of Reliable Recovery on Health Care Costs and Productivity Losses in Emotional Disorders

Despite the high economic costs associated with emotional disorders, relatively few studies have examined the variation in costs according to whether the patient has achieved a reliable recovery. The aim of this study was to explore differences in health care costs and productivity losses between primary care patients from a previous randomized controlled trial (RCT)-PsicAP-with emotional symptoms who achieved a reliable recovery and those who did not after transdiagnostic cognitive-behavioral therapy (TD-CBT) plus treatment as usual (TAU) or TAU alone. Sociodemographic and cost data were obtained for 134 participants treated at five primary care centers in Madrid for the 12-month posttreatment period. Reliable recovery rates were higher in the patients who received TD-CBT + TAU versus TAU alone (66% vs. 34%, respectively; chi-square = 13.78, df = 1, p < .001). Patients who did not achieve reliable recovery incurred more costs, especially associated with general practitioner consultations (t = 3.01, df = 132, p = .003), use of emergency departments (t = 2.20, df = 132, p = .030), total health care costs (t = 2.01, df = 132, p = .040), and sick leaves (t = 1.97, df = 132, p = .048). These findings underscore the societal importance of achieving a reliable recovery in patients with emotional disorders, and further support the value of adding TD-CBT to TAU in the primary care setting.

Assessing the Quick Inventory of Depressive Symptomatology Self-Report scores to predict continuous employment in mood disorder patients

Objective

Depression significantly impacts the job performance and attendance of workers, leading to increased absenteeism. Predicting occupational engagement for individuals with depression is of paramount importance. This study aims to determine the cut-off score which predicts continuous employment for patients with mood disorders using the Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR).

Methods

In a prospective observational trial conducted in Tokyo, 111 outpatients diagnosed with either major depressive disorder or bipolar depression were enrolled. Their employment statuses of these participants were tracked over a six-month period after their QIDS-SR scores were recorded. Based on their employment trajectories, participants were categorized into either continuous or non-continuous employment groups. Binary logistic regression was applied to examine the relationship between the QIDS-SR scores and employment outcomes, with adjustments for age, gender, and psychiatric diagnoses. Receiver operating characteristic curves were utilized to identify the optimal QIDS-SR cut-off values for predicting continuous employment.

Findings

Binary logistic regression demonstrated that a lower score on the QIDS-SR was linked to an elevated likelihood of continuous employment (adjusted odds ratio 1.15, 95% CI: 1.06-1.26, p=0.001). The optimal cut-off point, determined by the Youden Index, was 10/11, showcasing a 63% sensitivity and 71% specificity.

Conclusion

The results emphasize the potential of the QIDS-SR as a prognostic instrument for predicting employment outcomes among individuals with depressive disorders. These findings further underscore the importance of managing depressive symptoms to mild or lower intensities to ensure ongoing employment.

Clinical and economic implications of epilepsy management across treatment lines in Spain: a real-life database analysis

BACKGROUND

Epilepsy is a chronic brain disease characterized by recurrent seizures. We investigated real-world management of epilepsy across treatment lines in Spain, including healthcare resource use (HRU) and associated costs.

METHODS

This was a retrospective study of real-life data from epilepsy patients prescribed antiseizure medication (ASM) between January 2016 and December 2021. Patients were grouped according to their line of treatment (1st, 2nd, 3rd and 4th +) during the recruitment period. Demographic and clinical characteristics, comorbidities and concomitant medications were analyzed during the baseline period (6 months before starting treatment line); antiepileptic treatments, concomitant medications, HRU and associated costs were analyzed during follow-up.

RESULTS

The study included 5006 patients. Treatment duration decreased as treatment lines progressed (mean ± SD progression time: 523.2 ± 279.1 days from 1st to 2nd line, 351.6 ± 194.4 days from 2nd to 3rd line; 272.7 ± 139.3 days from 3rd to 4th + line). Significant HRU differences were found with subsequent treatment lines, including an increase in hospital admissions and patients on sick leave. Mean (95% CI) adjusted total costs per patient were €2974/year (2773-3175) in the 1st line and €5735/year (5043-6428) in the 4th + line. There was an increase in adjusted direct and total costs with subsequent treatment lines; the mean difference in total costs between cohorts was €2761 (p < 0.001). The highest direct costs were associated with epilepsy medication, days at the hospital and specialist visits.

CONCLUSION

Our data revealed a progressive increase in the use of resources and associated costs across subsequent epilepsy treatment lines.

Medication and rehabilitation of persons applying for disability pension due to depression: a register-based retrospective study from Finland

PURPOSE

To investigate how drug therapies and rehabilitation options have been utilised before applying for a disability pension due to depression.

METHODS

A retrospective register-based study of the 3604 persons who applied for a disability pension from the Social Insurance Institution of Finland (Kela) in 2019. In Finland, disability pension is usually preceded by an incapacity for work lasting for 1 year, during which time therapeutic procedures, which were analysed here, are applied.

RESULTS

Approximately half (56.0%) of the applicants had reimbursed purchases of two or more antidepressants during the 12 months preceding the disability pension application. Psychotherapy was received by 13.8% and 19.2% of the applicants 1 and 5 years before application, respectively. The share of applicants receiving some form of rehabilitation 1 year before application was 24.8% and 39.0% in the 5 years preceding application. During the 4 months before application, 19.6% of the applicants had no antidepressant purchases. In total, 12.2% of the applicants had both antidepressant treatment and psychotherapy in the year preceding the application, and 9.9% had neither psychotherapy nor antidepressant treatment.

CONCLUSION

Before applying for disability pension, only a minority of the applicants had received effective treatment for depression in the form of psychotherapy and antidepressants. However, most of the applicants had received some form of treatment, but it appears to have been insufficient.

[Analysis of Sickness-Related Days of Absence among Soldiers of the German Armed Forces from 2008 to 2018 Part 1: Retrospective Analysis with Comparison to the Statutory Health Insurance System]

BACKGROUND

Sickness-related absences are of particular importance both in the German armed forces and in the civilian sector.

THE AIM OF THIS STUDY

was to analyze the incidence of sick leave among soldiers in comparison to the working population covered by the statutory health insurance (SHI) system.

METHOD

According to the systematics of the SHI, the key figures on incapacity to work in the period 2008-2018 are calculated in an age- and gender-standardized manner. Likewise, a list of the TOP 20 ICD-10 diagnoses in relation to incapacity to work was determined, and their average annual rates of change were calculated for trend analysis.

RESULTS

The annual rate of sick leave among soldiers was between 1.5 and 2.3%, which was lower than that of the SHI (3.1 to 5.0%). The duration of illness (sick days per case) among soldiers was between 9.0-15.6 days per year, compared with 10.9-14.4 days in the SHI system. The sickness frequency (cases per 100 persons) was lower among soldiers (48.2-75.0 cases) than in the SHI (96.8-131.0 cases). Most days of absence among soldiers were due to "respiratory infections (J06)" with 13.2%, "stress reactions (F43)" with 8.7%, "other infectious gastroenteritis and colitis (A09)" with 6.5%, "back pain (M54)" with 4.4% and "depressive episode (F32)" with 4.0% of all days of absence and were comparable to the values in SHI. "Depressive episode (F32)", "injuries (T14)", sreactions (F43)", "respiratory infections (J06)" and "pregnancy complaints (O26)" showed the highest rates of increase of+6.1% to+3.6% of days off work.

CONCLUSION

For the first time, it was possible to compare the sickness rate of soldiers with that of the general population in Germany, which may also provide indications for further measures for primary, secondary and tertiary prevention. The lower sickness rate among soldiers compared with the general population is mainly due to a lower incidence of illness, with a similar duration and pattern of illness, but with an overall upward trend. The ICD-10 diagnoses "Depressive episode (F32)," "injuries (T14)," "stress reactions (F43)," "acute upper respiratory tract infections (J06)" and "pregnancy complaints (O26)," which are increasing at an above-average rate in relation to the number of days absent, require further analysis. This approach seems promising, for example, to generate hypotheses and ideas for further improvement of health care.

Quercetin mitigates depression-like behavior via the suppression of neuroinflammation and oxidative damage in corticosterone-induced mice

Depression is a clinically common and easily overlooked mental disease. Quercetin is a flavonoid compound, which has anti-inflammatory and antioxidant roles. Previous reports presented the anti-depressant role of quercetin. Nevertheless, the latent mechanism of the anti-depressant function of quercetin is blurry. This research aimed to probe its effects on corticosterone (CORT)-induced depression-like behaviors and explore the underlying mechanism. A depression model was established by subcutaneous injection of CORT (20 mg/kg). Thereafter, CORT-treated mice were given 40 mg/kg and 80 mg/kg of quercetin by gavage. This study found that quercetin mitigated depression-like behaviors, as evidenced by increased the number of line crossings, swimming time, and time spent in open arm and reduced thigmotaxis time in CORT-challenged mice in open field test and decreased immobility time as well as the swimming and climbing time in forced swim test and increased number of head dips, time spent and entries in open arm elevated plus maze test. Also, quercetin exerted anti-inflammatory and anti-oxidation effects in hippocampus and prefrontal cortex of CORT-induced mice. Additionally, quercetin alleviated the pathological injury of the liver tissue and weakened alkaline phosphatase (ALP) and alanine aminotransferase (ALT) concentrations of the serum in CORT-induced mice. Quercetin also suppressed Caspase-3 content but advanced vascular endothelial growth factor (VEGF) and brain derived neurotrophic factor (BDNF) contents in hippocampus of CORT-treated mice. Based on these results, quercetin mitigated CORT-induced depression-like behaviors, and the mechanism was partly related to the repression of neuroinflammation and oxidative damage.

Stakeholder views on work participation for workers with depression and intersectoral collaboration in depression care: a focus group study with a salutogenic perspective

OBJECTIVE

To explore how stakeholders in depression care view intersectoral collaboration and work participation for workers with depression.

DESIGN

Focus group study applying reflexive thematic analysis using a salutogenic perspective.

SETTING AND SUBJECTS

We conducted seven focus group interviews in six different regions in Norway with 39 participants (28 women); three groups consisted of general practitioners (GPs), two of psychologists and psychiatrists and two of social welfare workers and employers (of which one group also included GPs).

RESULTS

Stakeholders considered work participation salutary for most workers with depression, given the right conditions (e.g. manageable work accommodations and accepting and inclusive workplaces). They also highlighted work as an integral source of meaningfulness to many workers with depression. Early collaborative efforts and encouraging sick-listed workers to stay connected to the workplace were considered important to avoid long and passive sickness absences. Furthermore, stakeholders' views illuminated why intersectoral collaboration matters in depression care; individual stakeholders have limited information about a worker's situation, but through collaboration and shared insight, especially in in-person collaborative meetings, they (and the worker) can gain a shared understanding of the situation, thereby enabling more optimal support. Ensuring adequate information flow for optimal and timely follow-up of workers was also emphasized.

CONCLUSIONS

Stakeholders highlighted the salutary properties of work participation for workers with depression under the right conditions. Intersectoral collaboration could support these conditions by sharing insight and knowledge, building a shared understanding of the worker's situation, assuring proper information flow, and ensuring early and timely follow-up of the worker.

Depression symptoms reducing return to work: a meta-analysis of prospective studies

Objectives. This study was conducted to estimate the risk of return to work for people who experience symptoms of depression based on the pool of prospective data. Methods. All online articles in PubMed and Scopus which were accessible before November 2019 were searched. The odds ratios of each of the studies were pooled together to obtain an overall odds ratio. The pool of studies was with random effects. The analysis was performed based on the depression symptoms scale, type of disease and duration of follow-up. Two other aspects were examined in the analysis, one being the bias in the publication of studies and the other being the level of heterogeneity that was examined. Results. Thirty-five studies were selected for the meta-analysis. The pooled odds ratio indicates that the odds of return to work in people with depressive symptoms is 31% lower than in those without depressive symptoms. The funnel plot shows that there is asymmetry. The Egger test result was significant (p < 0.001) and there is publication bias. Conclusion. Depression symptoms after sick leave due to physical illness is a risk factor for not returning to work.

Personality-related and psychosocial correlates of sick leave days in Germany during the COVID-19 pandemic: findings of a representative survey

Background

The aim of our study was to assess the personality-related and psychosocial correlates of sick leave days in Germany during the COVID-19 pandemic.

Methods

We used data from a representative online-survey covering the general German adult population (data collection: mid-March 2022). We restricted our sample to full-time employed individuals aged 18 to 64 years (n = 1,342 individuals). Sick leave days in the preceding 12 months served as outcome measure. Validated and established tools were used to quantify personality characteristics and psychosocial factors (such as the Coronavirus Anxiety Scale or the De Jong Gierveld loneliness tool). Negative binomial regression models were used.

Results

After adjusting for various sociodemographic and health-related factors, regressions showed that a higher number of sick leave days was associated with lower levels of conscientiousness (IRR: 0.84, 95% CI: 0.73-0.97), higher levels of openness to experience (IRR: 1.19, 1.04–1.35), less coronavirus anxiety (IRR: 0.90, 95% CI: 0.86-0.93), and more depressive symptoms (IRR: 1.06, 1.02–1.11).

Conclusion

After adjusting for various sociodemographic and health-related factors, our study showed an association between personality-related and psychosocial factors with sick leave days. More research is required to clarify the underlying pathways.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00980-6.

Depression and loneliness may predict work inefficiency among professionally active adults

Purpose

Both depression and loneliness have been recognized as major public health issues, yet investigation into their role among young and middle-aged, professionally active persons is still required. The aim of the present study was to evaluate whether depression and loneliness may independently predict inefficiency at work among professionally active adults.

Methods

This is a cross-sectional study on a representative, nationwide sample. 1795 questionnaires were gathered from among professionally active adults from Poland from 1 to 31 July 2018 with a direct pen-and-paper interview. The sample was chosen by means of the stratified random method. The survey included a Patient Health Questionnaire (PHQ-9) to measure depression and questions, devised by the authors, relating to loneliness and inefficiency at work. Regression models were constructed with depression and loneliness as predictors of inefficiency at work, unadjusted and adjusted for selected sociodemographic, health- and work-related factors.

Results

In the unadjusted models, both depression and loneliness were independently associated with an increase of work inefficiency and absence from work, with effect sizes being higher for loneliness than for depression. After accounting for the control variables (i.e., sociodemographic, work- and health-related factors), the PHQ-9 score, but not the loneliness score, was associated with an increased probability of frequent thoughts about changing or leaving a job.

Conclusion

Depression and loneliness independently predicted occupational functioning and differentially affect its various aspects. Counteracting depression and loneliness among employees should be regarded as a public health priority.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-022-01869-1.

Prevalence of and factors associated with long-term sick leave in working-age adults with chronic low back pain in Germany

OBJECTIVE

There are little data on the impact of chronic low back pain (CLBP) on long-term sick leave. Thus, the aim was to investigate the prevalence of and the factors associated with long-term sick leave in working-age adults with CLBP in Germany.

METHODS

This retrospective study included adults aged 18-65 years diagnosed for the first time with CLBP in one of 1193 general practices in Germany between 2000 and 2019. CLBP was defined as the presence of two diagnoses of low back pain with > 90 days between them. Long-term sick leave was assessed in the year following the first diagnosis of low back pain, and was defined as > 42 days of absence from work for health-related reasons. In Germany, employees on sick leave lasting > 42 days are not paid by the employer anymore but by the health insurance fund. Finally, an adjusted logistic regression model was used to assess the association between predefined variables (e.g., age, sex, and comorbidities) and long-term sick leave.

RESULTS

A total of 59,269 working-age adults were included in this study [mean (SD) age 32.8 (11.5) years; 41.4% women]. The prevalence of long-term sick leave in the sample was 49.1%. Long-term sick leave was significantly associated with young age, male sex, and several physical and psychiatric comorbidities (e.g., reaction to severe stress and adjustment disorder, gastritis and duodenitis, and depression).

CONCLUSIONS

Based on these results, public health measures are urgently needed to mitigate the deleterious effects of CLBP on work participation in Germany.