The associations between personality characteristics and absenteeism: a cross-sectional study in workers with and without depressive and anxiety disorders

How to remain in working life with hearing loss - health factors for a sustainable work situation

BACKGROUND

Persons with hearing loss (HL) are a vulnerable group in working life. Studies have shown that they are more likely than the general population to be in part-time work, to be unemployed, receive disability pension, and to be on sick leave. Many workers with HL also experience unhealthy work conditions, such as jobs where they experience high demands combined with low control as well as safety concerns and social isolation. There is a lack of studies that focus on factors that promote a healthy, sustainable work situation for the target group.

OBJECTIVE

To investigate health factors that contribute to a sustainable work situation for employees with HL.

METHODS

The current study was a comparative, observational study with a cross-sectional design including a clinical population of adults with HL. Comparisons were made between workers with HL "in work" and workers with HL on "HL-related sick leave".

RESULTS

Seven health factors were identified. Those "in work" experienced a healthier work environment as well as lower levels of mental strain, hearing-related work characteristics and content, cognitively demanding work content, hearing-related symptoms, energy-demanding activities, and bodily aches and pain than those on "HL-related sick leave".

CONCLUSION

The results demonstrate a clear pattern regarding health factors for a sustainable working life. The type of job was not related to whether an individual was on sick leave or working. Rather, the work climate and the content of the work mattered.

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.

Sick leave duration as a potential marker of functionality and disease severity in depression

Objective: To discuss the impact of depression on work and how depression-related sick leave duration could be a potential indicator and outcome for measuring functionality in depression.Methods: Our review was based on a literature search and expert opinion that emerged during a virtual meeting of European psychiatrists that was convened to discuss this topic.Results: Current evidence demonstrates that depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions. A wide variety of pharmacological and non-pharmacological treatments and work-based interventions are effective in reducing depression-related sick leave duration and/or facilitating return to work. Recent real-world evidence showed that patients treated with antidepressant monotherapy appear to recover their working life faster than those receiving combination therapy. Although depression-related sick leave duration was found to correlate with severity of depressive symptoms, it cannot be used alone as a viable marker for disease severity.Conclusions: Given its multifactorial nature, depression-related sick leave duration is not on its own a viable outcome measure of depression severity but could be used as a secondary outcome alongside more formal severity measures and may also represent a useful measure of functionality in depression. Key pointsDepression in the working population and depression-related sick leave have a profound economic impact on societyDepression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditionsA wide variety of pharmacological and non-pharmacological treatments and work-based interventions have been shown to be effective in reducing depression-related sick leave duration and/or facilitating return to workIn terms of pharmacological intervention, recent real-world evidence has shown that patients treated with antidepressant monotherapy are able to recover their working life faster than those treated with combination therapyAlthough depression-related sick leave duration has been shown to correlate with severity of depressive symptoms, it is not a viable outcome measure of depression severity on its own, but could be used as secondary outcome alongside more formal clinician- and patient-rated severity measuresDepression-related sick leave duration may, however, represent a viable outcome for measuring functionality in depression.

Big five personality traits and physician-certified sickness absence

Although several studies show that personality traits are associated with absenteeism, few large-scale studies have examined these relationships prospectively, integrating survey data and register data on sickness absence. This study examines whether personality is associated with sickness absence, and whether health factors, gender, age, type of occupation and job satisfaction moderate this relationship. We combine survey data assessing the Big Five personality traits from a large sample of Norwegian employees aged 18–62 years ( N = 5017) with register data on physician-certified sickness absence up to four years after. Negative binomial regression analyses showed that extraversion was positively associated with subsequent sickness absence when controlling for several covariates, including health, work factors and previous spells of sickness absence. Neuroticism also showed significant positive associations with sick leave; however, the association diminished when accounting for previous spells of sickness absence. Moderator analyses demonstrated that age and type of occupation affected some of the associations between personality and sickness absence. The findings indicate that – in addition to general health promotion measures – specific interventions targeting individuals high in extraversion may be beneficial in reducing sick leave. How socio-demographic and work-related factors moderate the relationship between personality and sickness absence may be an interesting future research area.

Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research

BACKGROUND

The Netherlands Study of Depression and Anxiety (NESDA; N_baseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders.

METHODS

A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders.

RESULTS

All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders.

CONCLUSION

NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.

Causes of Sickness Absenteeism in Europe-Analysis from an Intercountry and Gender Perspective

This study aims to extract and explain the territorially varied relation between socioeconomic factors and absence rate from work due to own illness or disability in European countries in the years 2006-2020. For this purpose, several causes were identified, depending on men and women. To explain the absenteeism and emphasize gender as well as intercountry differences, geographically weighted regression was applied. For men, there were five main variables that influenced sickness absence: body mass index, the average rating of satisfaction by job situation, employment in the manufacturing sector, social benefits by sickness/health care, and performing health-enhancing physical activity. For women, there were five main variables that increased the absence rate: the risk of poverty or social exclusion, long-standing illness or health problems, employment in the manufacturing sector, social protection benefits, and deaths due to pneumonia. Based on the conducted research, it was proven that the sickness absence observed in the analyzed countries was highly gender and spatially diverged. Understanding the multifactorial factors playing an important role in the occurrence of regional and gender-divergent sickness absence may be a good predictor of subsequent morbidity and mortality as well as be very useful to better prevent this outcome.

Workplace discrimination as risk factor for long-term sickness absence: Longitudinal analyses of onset and changes in workplace adversity

Workplace discrimination may affect the health of the exposed employees, but it is not known whether workplace discrimination is also associated with an increased risk of long-term sickness absence. The aim of this study was to examine the longitudinal associations of changes in and onset of workplace discrimination with the risk of long-term sickness absence. Data on workplace discrimination were obtained from 29,597 employees participating in survey waves 2004, 2006, 2008 and/or 2010 of the Finnish Public Sector Study. Four-year changes in long-term sickness absence (≥10 days of medically certified absence with a mental or non-mental diagnosis) were assessed. This covered successive study waves in analyses of onset of workplace discrimination as well as fixed effect analyses of change in workplace discrimination (concurrent i.e. during the exposure year and 1-year lagged i.e. within one year following exposure), by using each employee as his/her own control. The risk of long-term sickness absence due to mental disorders was greater for employees with vs. without onset of workplace discrimination throughout the 4-year period, reaching a peak at the year when the onset of discrimination was reported (adjusted risk ratio 2.13; 95% confidence interval (CI) 1.80–2.52). The fixed effects analyses showed that workplace discrimination was associated with higher odds of concurrent, but not 1-year lagged, long-term sickness absence due to mental disorders (adjusted odds ratio 1.61; 95% CI 1.33–1.96 and adjusted odds ratio 1.02; 95% CI 0.83–1.25, respectively). Long-term sickness absence due to non-mental conditions was not associated with workplace discrimination. In conclusion, these findings suggest that workplace discrimination is associated with an elevated risk of long-term sickness absence due to mental disorders. Supporting an acute effect, the excess risk was confined to the year when workplace discrimination occurred.

The role of borderline personality disorder symptoms on absenteeism & work performance in the Netherlands Study of Depression and Anxiety (NESDA)

BACKGROUND

Symptoms of borderline personality disorder (BPD) were previously found to be associated with decreased work performance, even after controlling for depressive and anxiety disorders. Furthermore, co-occurrence of BPD and affective disorders is common. Therefore, we examined the effect of BPD symptoms on occupational functioning in workers with affective disorders.

METHODS

Healthy workers (n = 287), workers with current depression/anxiety only (n = 195), workers with BPD symptoms only (n = 54), and workers with both depression/anxiety and BPD symptoms (n = 103) were selected from the Netherlands Study of Depression and Anxiety (NESDA). Both a categorical and dimensional approach were used to cross-sectionally study the effect of BPD symptoms on work performance and absenteeism.

RESULTS

Compared to healthy controls, all symptomatic groups had impaired occupational functioning. Workers with current depression/anxiety had higher long-term absenteeism (OR = 3.59; 95%CI:1.83-7.02) and impaired work performance (OR = 7.81; 95%CI:4.44-13.73), workers with BPD symptoms only had higher impaired work performance (OR = 6.02 95%CI:2.76-13.09), and workers with both depression/anxiety and BPD symptoms had higher long-term absenteeism (OR = 3.66 95%CI:1.69-7.91) and impaired work performance (OR = 10.41 95%CI:5.38-20.15). No difference was found between the (symptomatic) groups. In the dimensional analysis, all associations between BPD symptoms and occupational measures disappeared when depressive symptoms were added. Depressive and BPD symptoms were highly correlated (r = .67).

CONCLUSIONS

Our findings confirm that both affective disorders and BPD symptoms are associated with occupational dysfunction. The effect of BPD symptoms however, seems mediated by depressive symptoms. This would suggest that focusing on affective symptoms in occupational health may be effective to improve occupational functioning in persons with BPD.

Personality Factors and Sick Leave Days. Evidence from a Nationally Representative Longitudinal Study in Germany

Background: The question of whether employees’ sickness absence from the workplace depends on personality has been researched. Existing evidence mostly stems from cross-sectional studies, mainly showing that personality factors were not associated with the number of sick leave days, except for neuroticism, which was positively associated with sick leave days. Based on the above, it remains an under researched question whether intraindividual changes in personality factors are associated with changes in sick leave days. Thus, based on a nationally representative sample, the current study aimed to investigate the relationship between personality factors and sick leave days longitudinally based on a nationally representative sample of individuals in Germany. Methods: The present study used data from the German Socio-Economic Panel (GSOEP), a longitudinal survey of private households in Germany. Information from the years 2005, 2009, 2013 were used. The Big Five Inventory-GSOEP (BFI-S) was used to measure personality. Sick leave days in the preceding year were recorded. Poisson fixed effects regressions were used. Results: Adjusting for potential confounders, regressions showed that increases in neuroticism were associated with increased sick leave days. The longitudinal association between extraversion and sick leave days was marginally significant (p < 0.10). Other personality factors were not significantly associated with sick leave days. In addition, sick leave days increased with worsening self-rated health, presence of severe disability and increasing age. Conclusions: The findings of the current study highlight the association between neuroticism and sick leave days longitudinally. Further research is required to elucidate the underlying mechanisms.

The Impacts of Childhood Trauma on Psychosocial Features in a Chinese Sample of Young Adults

OBJECTIVE

The aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features in a Chinese sample of young adults.

METHODS

A survey was carried out in a group of 555 university students by using Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Questionnaire (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS). The moderate-severe cut-off scores for CTQ were used to calculate the prevalence of childhood trauma, and then psychosocial features were compared between individuals with and without childhood trauma.

RESULTS

A proportion of 18.6% of university students had self-reported childhood trauma exposures. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and psychoticism and neuroticism dimensions of EPQ (t=4.311-5.551, p<0.001); while lower scores of SSRS and extraversion dimension of EPQ (t=-4.061- -3.039, p<0.01). Regression analyses further revealed that scores of SAS and DAS were positively (Adjusted B=0.211-0.230, p<0.05), while scores of SSRS were negatively (Adjusted B=-0.273- -0.240, p<0.05) associated with specific CTQ scores.

CONCLUSION

Childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.

Predictors of Sustained Employment Among Individuals With Serious Mental Illness: Findings From a 5-Year Naturalistic Longitudinal Study

Despite decades of research, understanding of the employment trajectories of individuals with serious mental illnesses remains elusive. We conducted a 5-year prospective, longitudinal study using a geographically broad sample of individuals who met established criteria for sustained competitive employment (N = 529). We collected data on an annual basis with a specifically designed survey instrument. Despite stable employment at study entry, more than half of the participants experienced work interruptions during the 5-year follow-up period. Predictors of sustained employment included the absence of a trauma diagnosis, Social Security disability income, psychiatric hospitalizations, and difficulties with daily functioning. The presence of a higher quality of life, workplace supports, and a flexible job were also predictive. Results dispel the myth that people with serious mental illnesses cannot be employed for prolonged periods. Interruptions in work trajectories, however, suggest that longer-term supports may increase individuals' capacity to maintain stable employment.

Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review

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.

Borderline personality symptoms and work performance: a population-based survey

BACKGROUND

This study aims to elucidate the interplay between borderline personality symptoms and working conditions as a pathway for impaired work performance among workers in the general population.

METHODS

Cross-sectional data from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) were used, including 3672 workers. Borderline personality symptoms were measured with the International Personality Disorder Examination (IPDE) questionnaire. Working conditions (decision latitude, psychological job demands, job security and co-worker support) were assessed with the Job Content Questionnaire (JCQ). Impaired work performance was assessed as total work loss days per month, defined as the sum of days of three types of impaired work performance (inability to work, cut-down to work, and diminished quality at work). These were assessed with the WHO Disability Assessment Schedule (WHO-DAS). Common mental disorders (CMD) were assessed with the Composite International Diagnostic Interview (CIDI).

RESULTS

Number of borderline personality symptoms was consistently associated with impaired work performance, even after controlling for type or number of adverse working conditions and co-occurrence of CMD. Borderline personality symptoms were associated with low decision latitude, job insecurity and low co-worker support. The relationship between borderline personality symptoms and work performance diminished slightly after controlling for type or number of working conditions.

CONCLUSIONS

The current study shows that having borderline personality symptoms is a unique determinant of work performance. This association seems partially explained through the impact of borderline personality symptoms on working conditions. Future studies are warranted to study causality and should aim at diminishing borderline personality symptoms and coping with working conditions.

Person-related factors associated with work participation in employees with health problems: a systematic review

PURPOSE

The objective of this systematic review was to explore and provide systematically assessed information about the association between person-related factors and work participation of people with health problems. The research question was: what is the association between selected person-related factors and work participation of workers with health problems?

METHODS

A systematic review was carried out in PubMed and PsycINFO to search for original papers published between January 2007 and February 2017. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. The quality of evidence was assessed using the GRADE framework for prognostic studies.

RESULTS

In total, 113 studies were included, all of which addressed the association between person-related factors and work participation. The factors positively associated with work participation were positive expectations regarding recovery or return to work, optimism, self-efficacy, motivation, feelings of control, and perceived health. The factors negatively associated with work participation were fear-avoidance beliefs, perceived work-relatedness of the health problem, and catastrophizing. Different coping strategies had a negative or a positive relationship with work participation.

CONCLUSIONS

The results of this review provide more insight into the associations between different cognitions and perceptions and work participation. The results of this study suggest that person-related factors should be considered by occupational- and insurance physicians when they diagnose, evaluate or provide treatment to employees. Further research is required to determine how these physicians could obtain and apply such information and whether its application leads to a better quality of care.

The impact of conscientiousness, mastery, and work circumstances on subsequent absenteeism in employees with and without affective disorders

BACKGROUND

High numbers of employees are coping with affective disorders. At the same time, ambitiousness, achievement striving and a strong sense of personal control and responsibility are personality characteristics that are nowadays regarded as key to good work functioning, whereas social work circumstances tend to be neglected. However, it is largely unkown how personality characteristics and work circumstances affect work functioning when facing an affective disorder. Given the high burden of affective disorders on occupational health, we investigate these issues in the context of affective disorders and absenteeism from work. The principal aim of this paper is to examine whether particular personality characteristics that reflect self-governance (conscientiousness and mastery) and work circumstances (demands, control, support) influence the impact of affective disorders on long-term absenteeism (>10 working days).

METHODS

Baseline and 1-year follow-up data from 1249 participants in the Netherlands Study of Depression and Anxiety (NESDA) in 2004-2006 was employed. Multivariate logistic regression analyses were performed, including interaction effects between depressive, anxiety, and comorbid disorders and personality and work circumstances.

RESULTS

In general, mastery and conscientiousness increased nor diminished odds of subsequent long-term absenteeism, whereas higher job support significantly decreased these odds. Interaction effects showed that the impact of affective disorders on absenteeism was stronger for highly conscientious employees and for employees who experienced high job demands.

CONCLUSIONS

Affective disorders may particularly severely affect work functioning of employees who are highly conscientious or face high psychological job demands. Adjusting working conditions to their individual needs may prevent excessive work absence.

Duration of Absence from Work Is Related to Psychopathology, Personality, and Sociodemographic Variables in a Longitudinal Cohort

OBJECTIVE

To examine, in a non-clinical sample, the association of psychopathology, personality, sociodemographic information, and psychosocial indicators of non-occupational functioning with the duration of absence from work in the past 12 months.

METHOD

A longitudinal community cohort of 591 adults from Switzerland was analyzed using multilevel ordered logistic regression, with several alternative models as robustness checks. Psychopathology was assessed using the total score (Global Severity Index) of the Symptom Check List-90 Revised.

RESULTS

The highest psychopathology levels were associated with absences of 3 or more week duration, largely independently of age. Extraversion and being divorced, widowed or separated also corresponded with longer absences from work in some analyses. No effect of sex was found. Most effects tested were not statistically significant and estimates showed large uncertainty.

CONCLUSION

Although tentative, our results suggest a possible influence of psychopathology on work participation. It may thus be desirable in insurance-medical appraisals of work ability to include instruments for measuring psychopathology.

Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials

Common mental disorders (CMDs) are highly prevalent in the working population, and are associated with long-term sickness absence and disability. Workers on sick leave with CMDs would benefit from interventions that enable them to successfully return to work (RTW). However, the effectiveness of RTW interventions for workers with a CMD is not well studied. The objective of this review is to assess the effectiveness of existing workplace and clinical interventions that were aimed at enhancing RTW. A systematic review of studies of interventions for improving RTW in workers with a CMD was conducted. The main outcomes were proportion of RTW and sick-leave duration until RTW. Randomized controlled trials (RCTs) were identified from Medline/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource and management databases from January 1995 to 2016. Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently homogeneous in different comparison groups and assessed the overall quality of the evidence. We reviewed 2347 abstracts from which 136 full-text articles were reviewed and 16 RCTs were included in the analysis. Combined results from these studies suggested that the available interventions did not lead to improved RTW rates over the control group [pooled risk ratio 1.05, 95% confidence interval (CI) 0.97-1.12], but reduced the number of sick-leave days in the intervention group compared to the control group, with a mean difference of -13.38 days (95% CI -24.07 to -2.69).

Longitudinal Associations Between Biopsychosocial Factors and Sustainable Return to Work of Sick-Listed Workers with a Depressive or Anxiety Disorder

PURPOSE

Only a limited number of studies have investigated return to work of sick-listed workers with mental health problems, and more knowledge is needed about the influence of non-disorder-related factors. This study aimed to identify longitudinal associations between demographic, personality, disorder-related and work-related characteristics and sustainable return to work of sicklisted workers with a depressive or anxiety disorder.

METHODS

We used data of a large Dutch cohort study to prospectively study longitudinal associations between biopsychosocial factors and sustainable return to work in 2 years. Associations were studied by means of univariable and multivariable logistic regression analysis. Participants who were sick-listed at baseline and had a lifetime diagnosis of a depressive and/or anxiety disorder were included in this study (N = 215).

RESULTS

In 2 years, 51.6% of the participants returned to work sustainably. Age, household income, extraversion, employment status, skill discretion and job security were significantly (P B 0.05) associated with sustainable RTW in 2 years in the univariable analyses. The multivariable analysis revealed significant associations between sustainable return to work and age (OR per 10 years = 0.67; 95% CI 0.47–0.95), household income (OR per 100 Euro’s a month = 1.04; 95% CI 1.00–1.08) and being on sickness benefit versus being (self-)employed (OR 0.39; 95% CI 0.20–0.77).

CONCLUSIONS

In the long-run not disorder-related factors, but an older age, the absence of a job and a low household income seem to complicate return to work. Policy and research should focus on facilitators and barriers for return to work of workers with these characteristics.

Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis

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.

Genetic and environmental contributions to the relationship between internalizing disorders and sick leave granted for mental and somatic disorders

This study investigates the degree to which internalizing disorders (anxiety and mood disorders) are prospectively associated with sick leave granted for mental and somatic disorders, and the extent to which common genetic and environmental risk factors influence these relationships. Data include self-reported symptoms of psychological distress from 7,598 young adult twins and diagnostic interviews on a subsample of 2,766 adult twins, subsequently linked to registry data on sick leave. Regression analyses and multivariate twin models were used to investigate the relationship between internalizing disorders and sick leave. Internalizing disorders were associated with sick leave granted for both mental disorders and somatic disorders. The association between internalizing disorders and sick leave granted for mental disorders was influenced by genetic and non-shared environmental factors, while the association between internalizing disorders and sick leave granted for somatic disorders could be explained by common genetic factors alone. Monozygotic twins discordant for internalizing disorders differed significantly in rates of sick leave granted for mental but not somatic disorders. In conclusion, internalizing disorders in young adults predict sick leave granted for both mental and somatic disorders. Environmental risk factors for internalizing disorders seem to influence sick leave granted for mental disorders, but not sick leave granted for somatic disorders.

Effects of personality on overtime work: a cross-sectional pilot study among Japanese white-collar workers

Background

As detailed associations between personality and long work hours are unclear, we assessed associations between personality dimensions and overtime work among Japanese white-collar workers.

Methods

From records of hours worked over 12 months by 267 office workers in an organization within the service industry, average overtime work hours per month and occurrence of excessive overtime was determined for each worker. Excessive overtime was defined as >  45 overtime work hours per month for at least one month. Responses to a questionnaire assessing socio-demographic and workplace-related factors and the Big Five personality test were analyzed. Associations between personality factors and overtime work were assessed by multivariate logistic regression analysis.

Results

Low Extraversion was associated with excessive overtime work (OR 2.02, 95%CI 1.02 – 4.02, P =  0.04).

Conclusions

It is suggested that workers with low Extraversion can’t share work when busy to avoid excessive overtime. Personality factors should be considered in studies evaluating work time. Moreover, strengthening communication among workers with low Extraversion may reduce excessive overtime work and associated health problems.

Perceived impeding factors for return-to-work after long-term sickness absence due to major depressive disorder: a concept mapping approach

Objective

The purpose of the present study was to explore various stakeholder perspectives regarding factors that impede return-to-work (RTW) after long-term sickness absence related to major depressive disorder (MDD).

Methods

Concept mapping was used to explore employees', supervisors' and occupational physicians' perspectives on these impeding factors.

Results

Nine perceived themes, grouped in three meta-clusters were found that might impede RTW: Person, (personality / coping problems, symptoms of depression and comorbid (health) problems, employee feels misunderstood, and resuming work too soon), Work (troublesome work situation, too little support at work, and too little guidance at work) and Healthcare (insufficient mental healthcare and insufficient care from occupational physician). All stakeholders regarded personality/coping problems and symptoms of depression as the most important impeding theme. In addition, supervisors emphasized the importance of mental healthcare underestimating the importance of the work environment, while occupational physicians stressed the importance of the lack of safety and support in the work environment.

Conclusions

In addition to the reduction of symptoms, more attention is needed on coping with depressive symptoms and personality problems in the work environment support in the work environment and for RTW in mental healthcare, to prevent long term sickness absence.

Personality disorders and long-term sick leave: a population-based study of young adult Norwegian twins

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.