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Selinheimo S, Gluschkoff K, Kausto J, Turunen J, Koskinen A, Väänänen A. The association of sociodemographic characteristics with work disability trajectories during and following long-term psychotherapy: a longitudinal register study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:621-630. [PMID: 37432409 PMCID: PMC10960900 DOI: 10.1007/s00127-023-02523-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/30/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE This register-based study examined the trajectories of depression or anxiety disorder-related work disability during and following long-term psychotherapy and identified sociodemographic factors that indicate membership in different trajectory groups. METHODS Data were drawn from national registers (Statistics Finland, Social Insurance Institution of Finland). Participants included a random sample of Finnish working-age individuals (18-55 years) who started psychotherapy treatment between 2011 and 2014 and were followed for 5 years: 1 year before and 4 years after the onset of psychotherapy (N = 3 605 individuals; 18 025 person-observations across five time points). Group-based trajectory modeling was applied to assign individuals to work disability trajectories by the number of annual mental health-related work disability months. Multinomial logistic regression was used to examine the associations between trajectory group membership and baseline sociodemographic factors of age, gender, occupational status, and geographical area of residence. RESULTS Four mental health-related work disability trajectories were identified: stable very low (72%), decrease (11%), persistent low (9%) and persistent high (7%). Those with older age, female gender, lower occupational status, and living in sparsely populated geographical areas were more likely to belong to the most unfavorable trajectory group of persistent high work disability. The presence of multiple risk characteristics substantially increased the probability of belonging to the most adverse trajectory group. CONCLUSIONS Sociodemographic factors were associated with the course of mental health-related work disability in association with psychotherapy. Rehabilitative psychotherapy does not function as an equal support resource for work ability in all parts of the population.
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Affiliation(s)
- Sanna Selinheimo
- Finnish Institute of Occupational Health, Työterveyslaitos, PO Box 18, 00032, Helsinki, Finland.
| | - Kia Gluschkoff
- Finnish Institute of Occupational Health, Työterveyslaitos, PO Box 18, 00032, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Johanna Kausto
- Finnish Institute of Occupational Health, Työterveyslaitos, PO Box 18, 00032, Helsinki, Finland
| | - Jarno Turunen
- Finnish Institute of Occupational Health, Työterveyslaitos, PO Box 18, 00032, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Työterveyslaitos, PO Box 18, 00032, Helsinki, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Työterveyslaitos, PO Box 18, 00032, Helsinki, Finland
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Rapisarda F, Bergeron N, Dufour MM, Guay S, Geoffrion S. Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada. Front Psychiatry 2023; 14:1112184. [PMID: 37275978 PMCID: PMC10232907 DOI: 10.3389/fpsyt.2023.1112184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Previous research has demonstrated the negative impact of the COVID-19 pandemic emergency on the wellbeing of healthcare workers. However, few research contributions reported a longitudinal evaluation of psychological distress and examined determinants of its duration and course over time. The present study aims to explore the impact of the pandemic emergency on HCWs mental health by adopting a longitudinal design and assessing mental health as combination of overlapping clinical symptoms (post-traumatic stress disorder, depression and anxiety). Methods Data were collected weekly through a mobile application during and after the first wave of COVID-19 in the province of Quebec, Canada, in 2020. Analysis was conducted on a final sample of 382 participants. Participants were grouped into "resilient" (RES) if they did not manifest clinical-level psychological distress during monitoring, "short-term distress" (STD) if distress exceeded the clinical threshold for 1-3 weeks, and longer-term distress (LTD) if it occurred for four or more weeks, even if not consecutively. Descriptive statistics for all variables were computed for each subgroup (RES, STD and LTD), and pairwise comparisons between each group for every descriptive variable were made using chi square statistics for categorical variables and t-test for continuous variables. Predictors of distress groups (STD and LTD vs RES) were assessed running multinomial hierarchical logistic regression models. Results In our sample, almost two third (59.4%) HCWs did not manifest moderate or severe distress during the monitoring time. Short-term distress, mostly post-traumatic symptoms that lasted for less than 4 weeks, were the most common distress response, affecting almost one third of participants. Longer psychological distress occurred only in a smaller percentage (12.6%) of cases, as a combination of severe posttraumatic, depressive and anxiety symptoms. Perceived occupational stress was the most significant risk factor; moreover individual, peritraumatic work and family risk and protective factors, were likely to significantly affect the stress response. Discussion Results tend to provide a more complex and resiliency-oriented representation of psychological distress compared to previous cross-sectional studies, but are in line with stress response studies. Findings allow us to better describe the profiles of distress response in STD and LTD groups. Participants that manifest short term distress experience acute stress reaction in which the interplay between personal, family and professional life events is associated with the stress response. Conversely, longer term distress response in HCWs presents a more complex mental health condition with an higher level of impairment and support needs compared to participants with short-term distress.
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Affiliation(s)
- Filippo Rapisarda
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
| | - Nicolas Bergeron
- Département de psychiatrie et d'addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marie-Michèle Dufour
- École de psychoéducation, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Guay
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
- Département de psychiatrie et d'addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- École de criminologie, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
| | - Steve Geoffrion
- Research Centre, Institut universitaire en sant9́ mentale de Montréal (IUSMM), Montreal, QC, Canada
- École de psychoéducation, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
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Kausto J, Gluschkoff K, Turunen J, Selinheimo S, Peutere L, Väänänen A. Psychotherapy and change in mental health-related work disability: a prospective Finnish population-level register-based study with a quasi-experimental design. J Epidemiol Community Health 2022; 76:jech-2022-218941. [PMID: 36113989 PMCID: PMC9554072 DOI: 10.1136/jech-2022-218941] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mental disorders are a major cause of work disability among the working-age population. Psychotherapy has shown to be an effective treatment for mental disorders, but the evidence is mainly based on small-scale randomised trials with relatively short follow-ups. We used population-based register data to examine the association between statutory rehabilitative psychotherapy and change in depression or anxiety-related work disability. METHODS We drew a nationally representative sample of the working-age population (aged 18-55 in 2010). The study group comprised all those who started rehabilitative psychotherapy in 2011-2014. A total of 10 436 participants who were followed from 3 years prior to 4 years after the onset of rehabilitative psychotherapy. This resulted in 83 488 observations. The annual total number of mental health-related work disability months (0 to 12) was calculated from the total number of annual compensated sickness absence and disability pension days. A quasi-experimental interrupted time series analysis was applied. RESULTS The onset of rehabilitative psychotherapy marked a decline in work disability in comparison to the counterfactual trend. Specifically, a 20% decrease in the level (incidence rate ratio, IRR 0.80; 95% CI 0.76 to 0.85) and a 48% decrease in the slope (IRR 0.52; 95% CI 0.50 to 0.54) of work disability were detected in comparison to the counterfactual scenario. No significant gender differences were observed. The decline in work disability was the steepest in the oldest age group. CONCLUSIONS This study suggests that statutory psychotherapy may decrease work disability at the population level. However, further evidence of causal inference and the potential heterogeneity of the association is required.
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Affiliation(s)
- Johanna Kausto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kia Gluschkoff
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Jarno Turunen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Laura Peutere
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Fit for Work and Life—an eight-week program for improvement of functionality and quality of life. NEUROPSYCHIATRIE 2022; 36:104-115. [PMID: 35428933 PMCID: PMC9012433 DOI: 10.1007/s40211-022-00415-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/13/2022] [Indexed: 11/18/2022]
Abstract
Background The current two-stage study focused on work integration and quality of life of patients in an acute psychiatric day care unit. There is evidence that a longer absence from work due to illness negatively affects job retention, life satisfaction and clinical prognosis. Furthermore, there are individual supportive methods that proved to be effective in work integration. We therefore developed a specific group program Fit for Work and Life (FWL) for patients in an acute psychiatric day care unit focusing on work integration in the first labor market (in contrast to work in institutions for people with disabilities/second labor market). Methods Between 2018 and 2020, 62 patients (intervention group; IG) were enrolled in an 8‑week prospective job integration program and compared to 74 patients (control group; CG) who received treatment as usual (partly retrospective survey). Patients of both groups held a job when entering treatment. Main outcome was defined as their working status 4 weeks after the end of treatment as well as self-reported life satisfaction. Results At the end of treatment (i.e. the week prior to discharge), the IG participants reported higher overall life satisfaction as well as higher health-, self- and living condition-related satisfaction than controls. Functional and clinical improvement during treatment was linked to subsequently returning to work. Functional improvement was further linked to higher life satisfaction. Mediational analysis revealed an indirect path from functional improvement on life satisfaction via working status, i.e. the higher functional improvement during treatment, the higher the chance of successfully returning to work, which in turn increased life satisfaction. Conclusion Our findings suggest that programs such as FWL are useful interventions for employed patients to improve reintegration into work and life and to help to increase life satisfaction.
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Björkenstam E, Helgesson M, Gustafsson K, Virtanen M, Hanson LLM, Mittendorfer-Rutz E. Occupational class and employment sector differences in common mental disorders: a longitudinal Swedish cohort study. Eur J Public Health 2021; 31:809-815. [PMID: 34269384 DOI: 10.1093/eurpub/ckab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent increases in common mental disorders (CMDs) among young adults are of great concern although studies of CMDs in young employees are sparse. This study investigated the independent and interacting effects of sector of employment, occupational class and CMDs. Additionally, associations between type of employment branch and CMDs within each sector were examined. METHODS This population-based longitudinal cohort study included 665 138 employees, 19-29 years, residing in Sweden in 2009. Employment sector (i.e. private/public) and occupational class (non-manual/manual workers) were measured in 2009. Risk estimates of CMDs, measured as new prescription of antidepressants and/or psychiatric care with a diagnosis of CMDs, between 2010 and 2016, were calculated as hazard ratios (HRs) with 95% confidence intervals (CIs), using Cox multivariable regression analysis. RESULTS Public sector employees (whereof 60% manual workers) had an elevated risk for CMDs compared to private sector employees [adjusted HR: 1.14 (95% CI 1.12-1.16)]. Within each sector, manual workers were at increased risk of CMDs compared to non-manual workers. There was an interaction between sector of employment and occupational class; manual workers in the public sector had the highest CMD risk [adjusted synergy index: 1.51 (95% CI 1.29-1.76)]. The most elevated risk for CMDs was observed in those employed in health and social services and the lowest risk among construction workers. CONCLUSION Sector of employment and occupational class play a role in CMDs in young employees. These findings should be taken into account in the attempts to reduce CMDs in the young working population.
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Affiliation(s)
- Emma Björkenstam
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Linda L M Hanson
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Viertiö S, Kiviruusu O, Piirtola M, Kaprio J, Korhonen T, Marttunen M, Suvisaari J. Factors contributing to psychological distress in the working population, with a special reference to gender difference. BMC Public Health 2021; 21:611. [PMID: 33781240 PMCID: PMC8006634 DOI: 10.1186/s12889-021-10560-y] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences. Methods We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women. Results Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41). Conclusions Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10560-y.
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Affiliation(s)
- Satu Viertiö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland. .,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland.,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maarit Piirtola
- University of Helsinki, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Jaakko Kaprio
- University of Helsinki, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tellervo Korhonen
- University of Helsinki, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Mauri Marttunen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland.,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland
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Combinations of Job Demands and Job Control and Future Trajectories of Sickness Absence and Disability Pension An 11-year Follow-up of Two Million Employees in Sweden. J Occup Environ Med 2020; 62:795-802. [PMID: 32472849 DOI: 10.1097/jom.0000000000001919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association between combinations of job demands/control and future sickness absence (SA) and disability pension (DP) trajectories over 11 years. METHODS A population-based prospective cohort study of female (n = 1,079,631) and male (n = 1,107,999) employees in 2001. With group-based trajectory analysis, we modeled the trajectories of annual mean SA/DP days in 2002 to 2012. We predicted trajectory memberships for job demands/control using multinomial regression. RESULTS We found three SA/DP trajectories for women (low stable, medium stable, and high increasing) and two for men (low stable and high increasing). Low demands/low control in women [odds ratio (OR) 1.42; 95% confidence interval (95% CI) 1.38 to 1.45], and low demands and medium/high control in men (equal OR of 1.23; 95% CI 1.18 to 1.28) were strongly associated with high increasing trajectory. CONCLUSION The associations between job demands/control varied between SA/DP trajectories and between sexes.
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Halonen JI, Mänty M, Pietiläinen O, Kujanpää T, Kanerva N, Lahti J, Lahelma E, Rahkonen O, Lallukka T. Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders? Soc Psychiatry Psychiatr Epidemiol 2020; 55:1021-1029. [PMID: 31893288 PMCID: PMC7395011 DOI: 10.1007/s00127-019-01823-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 12/24/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Physical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined. METHODS The data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000-2002, 2007 and 2012. We used 12,458 observations from 6159 employees, who were 40-60 years old at baseline. CMD were measured by the General Health Questionnaire (GHQ-12, cut-off point 3+). Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as "neither", "work exposure only", "CMD only", and "both". Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up. Additionally, synergy indices were calculated for the combined effects. RESULTS Those reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60-5.03), mental disorders (HR 5.41, 95% CI 3.87-7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49-5.71) when compared to those with neither. Synergy indices indicated that these associations were synergistic. Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work. CONCLUSIONS Identification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.
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Affiliation(s)
- Jaana I Halonen
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland.
- Finnish Institute of Occupational Health, Työterveyslaitos, 40, 00032, Helsinki, Finland.
- Finnish Institute for Health and Welfare, 30, 00271, Helsinki, Finland.
| | - Minna Mänty
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Tero Kujanpää
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, 8000, 90014, Oulu, Finland
| | - Noora Kanerva
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
- Finnish Institute of Occupational Health, Työterveyslaitos, 40, 00032, Helsinki, Finland
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Sikora A, Schneider G, Stegmann R, Wegewitz U. Returning to work after sickness absence due to common mental disorders: study design and baseline findings from an 18 months mixed methods follow-up study in Germany. BMC Public Health 2019; 19:1653. [PMID: 31823752 PMCID: PMC6902352 DOI: 10.1186/s12889-019-7999-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/22/2019] [Indexed: 01/14/2023] Open
Abstract
Background With nearly 30 % of the general population experiencing one mental disorder in 12 months, common mental disorders (CMDs) are highly prevalent in Germany and mainly affect the workforce. Therefore, the processes of successfully returning to work (RTW) and achieving a sustainable RTW (SRTW) are important not only for recovery but the prevention of negative consequences like job loss or disability retirement. While factors influencing and predicting the time until RTW are well-investigated in other countries, research on determinants of RTW and SRTW has received little attention in Germany. Consequently, this study aims to investigate the RTW and SRTW processes due to CMDs from the employees´ perspective in Germany. Methods This prospective cohort study uses a convergent parallel mixed methods design with a quantitative sample and qualitative sub-sample. Two hundred eighty-six participants of the quantitative study and a sub-sample of 32 participants of the qualitative study were included. The primary outcome of the quantitative study is the time until RTW and full RTW. The secondary outcome is the sustainability of RTW. The following measures will be used to cover work-, RTW- and health-related factors: working time, duration of sickness absences, functional ability, work ability, RTW self-efficacy, social support, work-privacy conflict, job satisfaction, job crafting and depressive symptoms. Quantitative and qualitative data will be integrated at the end. Discussion The paper provides an overview on study design, recruitment, sample characteristics and baseline findings of an 18 months mixed methods follow-up study in Germany. This study will provide evidence of (S)RTW processes and its influencing factors due to CMDs in Germany and therefore contribute to further improvement of its (S)RTW practices. Trial registration German Clinical Trials Register (ID: DRKS00010903, July 28, 2017, retrospectively registered).
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Affiliation(s)
- Alexandra Sikora
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany.
| | - Gundolf Schneider
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
| | - Ralf Stegmann
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
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Lallukka T, Kronholm E, Pekkala J, Jäppinen S, Blomgren J, Pietiläinen O, Lahelma E, Rahkonen O. Work participation trajectories among 1,098,748 Finns: reasons for premature labour market exit and the incidence of sickness absence due to mental disorders and musculoskeletal diseases. BMC Public Health 2019; 19:1418. [PMID: 31666045 PMCID: PMC6821029 DOI: 10.1186/s12889-019-7753-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants using large nationally representative data comprising over 1 million initially employed individuals and a 10-year follow-up for their work participation. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories. METHODS Young (25-38 years at baseline, n = 495,663) and midlife (39-52 years at baseline, n = 603,085) Finnish people, all working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for work participation and its determinants, as well as for computing the cumulative incidence of sickness absence. Latent class growth analysis was used to identify trajectories. RESULTS Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups. CONCLUSION Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups.
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Affiliation(s)
- Tea Lallukka
- Department of Public Health, University of Helsinki, P. O. Box 20, FIN-00014, Helsinki, Finland. .,Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
| | - Erkki Kronholm
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Johanna Pekkala
- Department of Public Health, University of Helsinki, P. O. Box 20, FIN-00014, Helsinki, Finland
| | - Sauli Jäppinen
- Department of Public Health, University of Helsinki, P. O. Box 20, FIN-00014, Helsinki, Finland.,The Social Insurance Institution of Finland (Kela), Helsinki, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland (Kela), Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, P. O. Box 20, FIN-00014, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, P. O. Box 20, FIN-00014, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, P. O. Box 20, FIN-00014, Helsinki, Finland
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Salmela J, Mauramo E, Lallukka T, Rahkonen O, Kanerva N. Associations between Childhood Disadvantage and Adult Body Mass Index Trajectories: A Follow-Up Study among Midlife Finnish Municipal Employees. Obes Facts 2019; 12:564-574. [PMID: 31484183 PMCID: PMC6876612 DOI: 10.1159/000502237] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/19/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Childhood disadvantage is associated with a higher risk of adult obesity, but little is known about its associations with body mass index (BMI) trajectories during adulthood. This study aimed first to identify adulthood BMI trajectories, and second to investigate how childhood disadvantage is associated with trajectory group membership. METHODS Data from the Helsinki Health Study, a longitudinal cohort study of initially 40- to 60-year-old employees of the City of Helsinki in Finland, were used. The baseline survey was conducted in 2000-2002, and similar follow-up surveys in 2007, 2012, and 2017. Based on self-reported BMI, participants' (n =5,266; 83% women) BMI trajectories, including their retrospectively reported BMI at the age of 25 years, were examined. Data on childhood disadvantage, including parental education and 7 types of childhood adversity (their own serious illness; parental divorce, death, mental disorder, or alcohol problems; economic difficulties at home; and peer group bullying) before the age of 16 years, were obtained from the baseline survey. Group-based trajectory modeling was used to identify BMI trajectories, and multinomial logistic regression to analyze the odds for trajectory group membership for the disadvantage variables. RESULTS Four ascending BMI trajectories in women and men were found: persistent normal weight (trajectory 1; women 35% and men 25%), normal weight to overweight (trajectory 2; women 41% and men 48%), normal weight to class I obesity (trajectory 3; women 19% and men 23%) and overweight to class II obesity (trajectory 4; women 5% and men 4%). Compared to trajectory 1, women with multiple adversities and repetitive peer bullying in childhood had greater odds of belonging to trajectories 3 and 4, whereas men with parental alcohol problems had greater odds of belonging to trajectory 4. For women and men, a low level of parental education was associated with a higher-level BMI trajectory. CONCLUSIONS Low parental education for both genders, multiple adversities and repetitive peer bullying in childhood among women, and parental alcohol problems among men increased the odds of developing obesity during adulthood. Further studies are needed to clarify how gender differences modify the effects of childhood disadvantage on adult BMI trajectories.
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Affiliation(s)
- Jatta Salmela
- University of Helsinki, Department of Public Health, Helsinki, Finland,
| | - Elina Mauramo
- University of Helsinki, Department of Public Health, Helsinki, Finland
| | - Tea Lallukka
- University of Helsinki, Department of Public Health, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ossi Rahkonen
- University of Helsinki, Department of Public Health, Helsinki, Finland
| | - Noora Kanerva
- University of Helsinki, Department of Public Health, Helsinki, Finland
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