Predictors of recurrent sickness absence among workers having returned to work after sickness absence due to common mental disorders

Abstract Purpose The aim of this study was to investigate if sickness absence and disability pension (SA/DP) in general and due to specific common mental disorders (CMDs) are associated with subsequent suicide attempt among women and men by taking familial factors (genetics and shared environment) into consideration. Methods This register-based cohort study includes 4871 twin pairs 18–65 years of age discordant for SA/DP due to CMDs 2005–2010. Twins were followed up for suicide attempt from inpatient and specialised outpatient care until December 2012. Conditional Cox proportional hazards regression models, adjusting for familial factors, were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results SA/DP due to CMDs was associated with a higher risk of suicide attempt (HR 3.14, CI 2.51–3.93). The risk of suicide attempt was five times higher among men and three times higher among women, compared to the SA/DP unaffected co-twins. In the diagnosis-specific analysis, SA/DP due to anxiety disorders resulted in the highest HR (4.09, CI 2.37–7.06) for suicide attempt, followed by depressive disorders (HR 3.70, CI 2.66–5.14) and stress-related disorders (HR 1.96, CI 1.35–2.84). The stratified analysis on zygosity indicates that there seems to be a genetic influence on the associations between SA/DP due to CMDs and suicide attempt, particularly among women and among those with SA/DP due to depressive disorders. Conclusions SA/DP due to CMDs was a risk factor for suicide attempt among women and men. Genetic factors might explain part of the associations for women and for those with SA/DP due to depressive disorders.

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Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106353 ◽

2020 ◽

Vol 77 (7) ◽

pp. 454-461 ◽

Cited By ~ 1

Author(s):

Marijke Keus van de Poll ◽

Lotta Nybergh ◽

Caroline Lornudd ◽

Jan Hagberg ◽

Lennart Bodin ◽

...

Keyword(s):

Mental Health ◽

Problem Solving ◽

Mental Disorders ◽

Occupational Health ◽

Sickness Absence ◽

Primary Outcome ◽

Common Mental Disorders ◽

Significant Group ◽

Secondary Outcomes

ObjectivesCommon mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.MethodsRandomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.ResultsA statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.ConclusionPSI was effective in reducing sickness absence which was the primary outcome in this study.

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External Validation and Update of a Prediction Rule for the Duration of Sickness Absence Due to Common Mental Disorders

Journal of Occupational Rehabilitation ◽

10.1007/s10926-016-9646-1 ◽

2016 ◽

Vol 27 (2) ◽

pp. 202-209 ◽

Cited By ~ 5

Author(s):

Giny Norder ◽

Corné A. M. Roelen ◽

Jac J. L. van der Klink ◽

Ute Bültmann ◽

J. K. Sluiter ◽

...

Keyword(s):

Mental Disorders ◽

Sickness Absence ◽

Common Mental Disorders ◽

External Validation ◽

Prediction Rule

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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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