Undetected Common Mental Disorders in Long-Term Sickness Absence

Background. Undetected Common Mental Disorders (CMDs) amongst people on sick leave complicate rehabilitation and return to work because appropriate treatments are not initiated. Aims. The aim of this study is to estimate (1) the frequencies of CMD, (2) the predictors of undetected CMD, and (3) the rate of return to work among sick listed individuals without a psychiatric disorder, who are registered on long-term sickness absence (LSA). Methods. A total of 2,414 incident individuals on LSA with a response rate of 46.4%, were identified for a two-phase study. The subsample of this study involved individuals registered on LSA who were sick-listed without a psychiatric sick leave diagnosis. In this respect, Phase 1 included 831 individuals, who were screened for mental disorders. In Phase 2, following the screening of Phase 1, 227 individuals were thoroughly examined by a psychiatrist applying Present State Examination. The analyses of the study were carried out based on the 227 individuals from Phase 2 and, subsequently, weighted to be representative of the 831 individuals in Phase 1. Results. The frequencies of undetected mental disorders among all sick-listed individuals were for any psychiatric diagnosis 21%, depression 14%, anxiety 4%, and somatoform disorder 6%. Conclusions. Undetected CMD may delay the initiation of appropriate treatment and complicate the rehabilitation and return to work.

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Compensating for non-response in a study estimating the incidence of mental disorders in long-term sickness absence by a two-phased design

Scandinavian Journal of Public Health ◽

10.1177/1403494810373673 ◽

2010 ◽

Vol 38 (6) ◽

pp. 625-632 ◽

Cited By ~ 2

Author(s):

Hans Jørgen Søgaard ◽

Per Bech

Keyword(s):

Mental Disorders ◽

Mental Disorder ◽

Sickness Absence ◽

Common Mental Disorders ◽

Phase 1 ◽

Somatoform Disorder ◽

Two Phase ◽

One Year ◽

Phase Design

Aims: The study compensates for the non-response that was observed in a previous study that estimated the frequencies of mental disorders in long-term sickness absence (LSA) (more than eight weeks of continuous sickness absence). In this study, the frequency of any mental disorder was estimated at 48% by a two-phase design and weighted logistic regression. The total non-response rate was 53.6%. This motivated the present study to compensate for non-response by applying adjustment of the weights and by multiple imputation of missing data in the estimation of the frequencies of mental disorders. Methods: The study took place in a Danish population of 120,000 inhabitants. During one year, all 2,414 incident individuals on LSA were identified. By a two-phase design 1,121 individuals were screened in Phase 1. In Phase 2, which was a subsample of Phase 1, 337 individuals participated in a psychiatric diagnostic examination applying Present State Examination as gold standard. The weighted analyses were based on scores of the screening instrument SCL-8AD compiled of SCL-8, SCL-ANX4, and SCL-DEP6 from the Common Mental Disorders Screening Questionnaire. In the present study, the variables sex, age, municipality, and social transfer income variables were used for the adjustment of weights in weighted analyses and in the imputation models. Results: The frequencies were: any mental disorder 46%—49%, depression 31%—36%, anxiety 13%—15%, and somatoform disorder 8%—9%. Conclusions: Irrespective of whether compensation for non-response was applied, the frequencies of mental disorders were similar. The variables used for the compensation were of problematic value.

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Barriers and Facilitators for Return to Work from the Perspective of Workers with Common Mental Disorders with Short, Medium and Long-Term Sickness Absence: A Longitudinal Qualitative Study

Journal of Occupational Rehabilitation ◽

10.1007/s10926-021-10004-9 ◽

2021 ◽

Author(s):

Margot C. W. Joosen ◽

Marjolein Lugtenberg ◽

Iris Arends ◽

Hanneke J. A. W. M. van Gestel ◽

Benedikte Schaapveld ◽

...

Keyword(s):

Mental Disorders ◽

Qualitative Study ◽

Return To Work ◽

Sickness Absence ◽

Common Mental Disorders ◽

Coping Behavior ◽

Work Conditions ◽

Barriers And Facilitators ◽

Structured Interviews

AbstractPurpose Although common mental disorders (CMDs) highly impact individuals and society, a knowledge gap exists on how sickness absence can be prevented in workers with CMDs. This study explores: (1) workers’ perceived causes of sickness absence; (2) perceived return to work (RTW) barriers and facilitators; and (3) differences between workers with short, medium and long-term sickness absence. Methods A longitudinal qualitative study was conducted involving 34 workers with CMDs. Semi-structured interviews were held at two time-points during their RTW process. The 68 interviews were audio-taped, transcribed and thematically analyzed to explore workers’ perspective on sickness absence causes, RTW barriers and facilitators, and compare data across the three sub-groups of workers. Results Workers reported various causes for their absence, including: (1) high work pressure; (2) poor work relationships; (3) unhelpful thoughts and feelings, e.g. lacking self-insight; and (4) ineffective coping behaviors. According to workers, RTW was facilitated by work adjustments, fulfilling relationships with supervisors, and adequate occupational health guidance. Workers with short-term leave more often reported favorable work conditions, and proactive coping behavior. In contrast, the long-term group reported reactive coping behavior and dissatisfaction with their work. Conclusion Supporting workers with CMDs in gaining self-awareness and regaining control, discussing the value of their work, and creating work conditions that enable workers to do valuable work, seem central for successful RTW and might prevent sickness absence. Supervisors play a key role in enabling workers to do valuable work and further research should focus on how supervisors can be supported in this task.

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Return to Work After Long-Term Sick Leave: Stories of Employed Women With Common Mental Disorders

International Journal of Disability Management ◽

10.1017/idm.2018.6 ◽

2018 ◽

Vol 13 ◽

Author(s):

Erika Wall ◽

John Selander

Keyword(s):

Mental Disorders ◽

Sick Leave ◽

Return To Work ◽

Common Mental Disorders ◽

Collective Narratives ◽

Management Perspective ◽

Female Employees ◽

Absence From Work ◽

Open Question

AbstractThe aim of this study is to investigate the perceptions of female employees on long-term sickness absence due to common mental disorders (CMDs), in relation to what they perceive would best help them to return to work. Data were collected through a survey answered by employees at a municipality in Sweden on long-term sick leave. Results of the current study are based on a part of that material, namely from 56 women with CMDs who responded to the final open question. The analysis involves two steps. Initially, we explored themes that form the accounts in the findings. Secondly, based on the themes, collective narratives, storylines were identified. Three different storylines were found to be prominent in the findings. The storylines describe how the participants collectively expressed themselves in relation to the possibilities for return to work, and the following storylines were derived:It feels like too much, Things are moving too fast,andI have to get out of here!. The findings are related to perceived demands, control and support. From a disability management perspective, we have learned the importance of restoring the balance between demands, control and support — not only to prevent absence from work, but also to facilitate return to work after a period of long-term sickness.

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Exploring the return-to-work process for workers partially returned to work and partially on long-term sick leave due to common mental disorders: a qualitative study

Disability and Rehabilitation ◽

10.3109/09638288.2010.541547 ◽

2011 ◽

Vol 33 (17-18) ◽

pp. 1625-1635 ◽

Cited By ~ 47

Author(s):

Erik Noordik ◽

Karen Nieuwenhuijsen ◽

Inge Varekamp ◽

Jac J. van der Klink ◽

Frank J. van Dijk

Keyword(s):

Mental Disorders ◽

Qualitative Study ◽

Sick Leave ◽

Return To Work ◽

Common Mental Disorders ◽

Work Process

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Beliefs About Return to Work Among Women During/After Long-Term Sick Leave for Common Mental Disorders: A Qualitative Study Based on the Theory of Planned Behaviour

Journal of Occupational Rehabilitation ◽

10.1007/s10926-020-09946-3 ◽

2021 ◽

Author(s):

Åsa Hedlund ◽

Eva Boman ◽

Marja-Leena Kristofferzon ◽

Annika Nilsson

Keyword(s):

Mental Disorders ◽

Sick Leave ◽

Return To Work ◽

Theory Of Planned Behaviour ◽

Professional Competence ◽

Common Mental Disorders ◽

Control Beliefs ◽

Planned Behaviour ◽

New Findings

Abstract Purpose Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD. Methods A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages–disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of—barriers to RTW). Results The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects. Conclusions By using the TPB, the present study was able to offer new findings on women’s beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.

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Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145234 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5234

Author(s):

Marijke Keus Van De Poll ◽

Gunnar Bergström ◽

Irene Jensen ◽

Lotta Nybergh ◽

Lydia Kwak ◽

...

Keyword(s):

Cost Effectiveness ◽

Problem Solving ◽

Mental Disorders ◽

Sickness Absence ◽

Common Mental Disorders ◽

Cost Benefit ◽

Cost Effective ◽

Production Loss ◽

The Cost

The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer’s perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer’s perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

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