Impact of common mental disorders on sickness absence in an occupational cohort study

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

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

Residual Work Capacity and (In)Ability to Work Fulltime Among a Year-Cohort of Disability Benefit Applicants Diagnosed with Mental and Behavioural Disorders

AIMS

Residual work capacity and inability to work fulltime are important outcomes in disability benefit assessment for workers with mental and behavioural disorders. The aim of this study is to gain insight into the prevalence and associations of socio-demographic and disease-related factors of these outcomes across different mental and behavioural diagnoses groups.

METHODS

A year cohort of anonymized register-data of patients diagnosed with a mental or behavioural disorder who claim a work disability benefit after two years of sick-leave was used (n = 12,325, age 44.5 ± 10.9, 55.5% female). Limitations in mental and physical functioning caused by disease are indicated according to the Functional Ability List (FAL). No residual work capacity was defined as having no possibilities to work, whereas inability to work fulltime was defined as being able to work less than 8 h per day.

RESULTS

The majority (77.5%) of the applicants were assessed with residual work capacity, of these 58.6% had an ability to work fulltime. Applicants diagnosed with (post-traumatic) stress, mood affective and delusional disorders showed significant higher odds for no residual work capacity and for inability to work fulltime, while other diagnoses groups, like adjustment and anxiety disorders, showed decreased odds for both assessment outcomes.

CONCLUSIONS

The type of mental and behavioural disorder seems important in the assessment of residual work capacity and inability to work fulltime, as the associations differ significantly between the specific diagnoses groups.

Opportunities for the Implementation of a Digital Mental Health Assessment Tool in the United Kingdom: Exploratory Survey Study

BACKGROUND

Every year, one-fourth of the people in the United Kingdom experience diagnosable mental health concerns, yet only a proportion receive a timely diagnosis and treatment. With novel developments in digital technologies, the potential to increase access to mental health assessments and triage is promising.

OBJECTIVE

This study aimed to investigate the current state of mental health provision in the United Kingdom and understand the utility of, and interest in, digital mental health technologies.

METHODS

A web-based survey was generated using Qualtrics XM. Participants were recruited via social media. Data were explored using descriptive statistics.

RESULTS

The majority of the respondents (555/618, 89.8%) had discussed their mental health with a general practitioner. More than three-fourths (503/618, 81.4%) of the respondents had been diagnosed with a mental health disorder, with the most common diagnoses being depression and generalized anxiety disorder. Diagnostic waiting times from first contact with a health care professional varied by diagnosis. Neurodevelopmental disorders (30/56, 54%), bipolar disorder (25/52, 48%), and personality disorders (48/101, 47.5%) had the longest waiting times, with almost half (103/209, 49.3%) of these diagnoses taking >6 months. Participants stated that waiting times resulted in symptoms worsening (262/353, 74.2%), lower quality of life (166/353, 47%), and the necessity to seek emergency care (109/353, 30.9%). Of the 618 participants, 386 (62.5%) stated that they felt that their mental health symptoms were not always taken seriously by their health care provider and 297 (48.1%) were not given any psychoeducational information. The majority of the respondents (416/595, 77.5%) did not have the chance to discuss mental health support and treatment options. Critically, 16.1% (96/595) did not find any treatment or support provided at all helpful, with 63% (48/76) having discontinued treatment with no effective alternatives. Furthermore, 88.3% (545/617) of the respondents) had sought help on the web regarding mental health symptoms, and 44.4% (272/612) had used a web application or smartphone app for their mental health. Psychoeducation (364/596, 61.1%), referral to a health care professional (332/596, 55.7%), and symptom monitoring (314/596, 52.7%) were the most desired app features. Only 6.8% (40/590) of the participants said that they would not be interested in using a mental health assessment app. Respondents were the most interested to receive an overall severity score of their mental health symptoms (441/546, 80.8%) and an indication of whether they should seek mental health support (454/546, 83.2%).

CONCLUSIONS

Key gaps in current UK mental health care provision are highlighted. Assessment and treatment waiting times together with a lack of information regarding symptoms and treatment options translated into poor care experiences. The participants' responses provide proof-of-concept support for the development of a digital mental health assessment app and valuable recommendations regarding desirable app features.

Reducing sickness absence and stigma due to mental health difficulties: a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail)

BACKGROUND

Common mental disorders are the leading cause of workplace absences. The Prevail intervention programme aims to reduce stigma and to educate staff and managers about evidence-based low intensity psychological interventions for common mental disorders (depression, anxiety, stress, and distress). Prevail is innovative in taking a public health approach. It is designed to be given to all employees irrespective of their past or current mental health. Prevail was evaluated in three studies examining: (1) the acceptability of the intervention and perceived usefulness; (2) whether the intervention altered stigmatic attitudes and motivation to seek help; and (3) whether the intervention reduced sickness absence, both overall and due to mental health problems.

METHODS

A two-armed cluster randomised control trial (RCT) evaluated the effectiveness of Prevail. Employees (N = 1051) at a large UK government institution were randomised to an active intervention or control arm in teams identified by their managers (n = 67). Employees in the active arm received the Prevail Staff Intervention. The managers in the active arm also received the Prevail Managers Intervention. Participants' satisfaction and analysis of the Prevail Intervention were gathered by a bespoke questionnaire. Questionnaire measures of attitudes to mental health and mental health stigma were taken 1-2 weeks prior to the intervention and approximately 4 weeks post-intervention. Data relating to sickness absence were gathered via the official records in the time period 3-month post-intervention and for the same period 12 months earlier.

RESULTS

Prevail was evaluated highly favourably by both the staff and their managers. Prevail produced significant reductions in self-stigma and anticipated stigma due to mental health difficulties. Crucially, sickness absence was significantly reduced by the Prevail Intervention.

DISCUSSION

Prevail achieved its goals of producing a palatable and engaging intervention that altered staff's attitudes and stigmatic beliefs related to mental health and, crucially, produced a strong reduction in work-pace absenteeism. As the Prevail programme is aimed at common mental health problems and was not specialised to this particular workforce, the study provides the evidence-base for a mental health intervention programme that could be used by many organisations across the world.

TRIAL REGISTRATION

ISRCTN12040087. Registered 04/05/2020. https://doi.org/10.1186/ISRCTN12040087 . A full protocol for the randomised control trial was published: Gray NS, Davies H, Snowden RJ: Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail). BMC Public Health 2020, 20(1):1-9.

Variations by ethnicity in referral and treatment pathways for IAPT service users in South London

BACKGROUND

The Improving Access to Psychological Therapies (IAPT) programme aims to provide equitable access to therapy for common mental disorders. In the UK, inequalities by ethnicity exist in accessing and receiving mental health treatment. However, limited research examines IAPT pathways to understand whether and at which points such inequalities may arise.

METHODS

This study examined variation by ethnicity in (i) source of referral to IAPT services, (ii) receipt of assessment session, (iii) receipt of at least one treatment session. Routine data were collected on service user characteristics, referral source, assessment and treatment receipt from 85 800 individuals referred to South London and Maudsley NHS Foundation Trust IAPT services between 1st January 2013 and 31st December 2016. Multinomial and logistic regression analysis was used to assess associations between ethnicity and referral source, assessment and treatment receipt. Missing ethnicity data (18.5%) were imputed using census data and reported alongside a complete case analysis.

RESULTS

Compared to the White British group, Black African, Asian and Mixed ethnic groups were less likely to self-refer to IAPT services. Black Caribbean, Black Other and White Other groups are more likely to be referred through community services. Almost all racial and minority ethnic groups were less likely to receive an assessment compared to the White British group, and of those who were assessed, all racial and ethnic minority groups were less likely to be treated.

CONCLUSIONS

Racial and ethnic minority service users appear to experience barriers to IAPT care at different pathway stages. Services should address potential cultural, practical and structural barriers.

Working conditions and common mental disorders in prison officers in the inland region of the state of São Paulo, Brazil

Abstract The prison officer profession is characterized by working in risky situations, which can harm officers’ mental health. This research aimed to analyze prison officers’ working conditions associated with Common Mental Disorders (CMD). This cross-sectional study was conducted with prison officers in four penitentiary units in the inland region of the State of São Paulo, Brazil, from January to August 2019. The Self-Reporting Questionnaire (SRQ-20) tool was employed to quantify the presence of CMDs. Poisson regression verified the association between variables with robust variance and adjusted for confounding factors to estimate the prevalence ratio (PR) and 95% confidence interval (CI). The study population comprised 331 prison officers (ASP), with a 33.5% frequency of CMDs. CMDs were higher among prison officers with a worse perception of working conditions (PR: 1.13; 95%CI%: 1.03-1.24), who suffered insults (PR: 1.18; 95%CI: 1.08-1.29), psychological harassment (PR: 1.23; 95%CI: 1.11-1.36) and sexual harassment (PR: 1.20; 95%CI: 1.03-1.40) in the last 12 months. CMDs were associated with work-related variables, such as worse environmental conditions within the prison and psychological and sexual violence.

Condições de trabalho e transtornos mentais comuns em agentes penitenciários do interior do estado de São Paulo, Brasil

Resumo A profissão de agente de segurança penitenciária (ASP) se caracteriza pelo trabalho em situações de perigo, o que pode desencadear prejuízos à sua saúde mental. O objetivo desta investigação foi analisar as condições de trabalho associadas aos transtornos mentais comuns (TMC) em ASP. Trata-se de um estudo transversal, realizado com ASP de quatro unidades prisionais do interior do estado de São Paulo, de janeiro a agosto de 2019. Para mensurar a presença de TMC, utilizou-se o instrumento Self-Reporting Questionnaire (SRQ-20). A associação entre as variáveis foi verificada por meio de regressão de Poisson com variância robusta, ajustada por fatores de confusão para a estimação da razão de prevalência (RP) e intervalo de confiança (IC) de 95%. A população de análise foi constituída por 331 ASP, com frequência de TMC de 33,5%. A presença de TMC foi mais elevada entre os ASP com pior percepção sobre as condições de trabalho (RP: 1,13; IC95%: 1,03-1,24), que sofreram insultos (RP: 1,18; IC95%: 1,08-1,29), assédio moral (RP: 1,23; IC95%: 1,11-1,36) e assédio sexual (RP: 1,20; IC95%: 1,03-1,40), nos últimos 12 meses. O TMC apresentou associação com variáveis relacionadas ao trabalho, tais como piores condições do ambiente no interior do cárcere e ocorrência de violências psicológica e sexual.

The Stigma and Self-Stigma Scales for attitudes to mental health problems: Psychometric properties and its relationship to mental health problems and absenteeism

The Stigma and Self-Stigma scales (SASS) measure multiple aspects of stigmatic beliefs about mental health problems, including cognitive aspects of stigma towards others (Stigma to Others) and emotional stigma toward others (Social Distance), anticipated stigma by others, self-stigma, avoidant coping strategies, and help-seeking intentions, alongside an index of social desirability. The properties of the SASS were investigated by employees of a large UK government organization. With minor exceptions, each of the SASS scales had strong psychometric properties, good internal reliability, and test-retest reliability. Social Distance, Anticipated Stigma, Self-Stigma, and Avoidant Coping were all strongly associated with a lack of help-seeking for mental health problems. Similarly, Stigma to Others, Self-Stigma, and Avoidant Coping were all associated with current mental health problems. Finally, absenteeism from the workplace was found to be negatively related to Stigma to Others, and positively related to Avoidant Coping and Anticipated Stigma. In conclusion, the SASS was able to measure several different forms of stigma about mental health simultaneously in people both with and without a history of mental health problems. The SASS can be used to monitor changes in mental health attitudes outcomes following intervention programs to investigate stigmatic attitudes to mental health problems across different samples.

The Stigma and Self-Stigma Scales for attitudes to mental health problems: Psychometric properties and its relationship to mental health problems and absenteeism

The Stigma and Self-Stigma scales (SASS) measure multiple aspects of stigmatic beliefs about mental health problems, including cognitive aspects of stigma towards others (Stigma to Others) and emotional stigma toward others (Social Distance), anticipated stigma by others, self-stigma, avoidant coping strategies, and help-seeking intentions, alongside an index of social desirability. The properties of the SASS were investigated by employees of a large UK government organization. With minor exceptions, each of the SASS scales had strong psychometric properties, good internal reliability, and test-retest reliability. Social Distance, Anticipated Stigma, Self-Stigma, and Avoidant Coping were all strongly associated with a lack of help-seeking for mental health problems. Similarly, Stigma to Others, Self-Stigma, and Avoidant Coping were all associated with current mental health problems. Finally, absenteeism from the workplace was found to be negatively related to Stigma to Others, and positively related to Avoidant Coping and Anticipated Stigma. In conclusion, the SASS was able to measure several different forms of stigma about mental health simultaneously in people both with and without a history of mental health problems. The SASS can be used to monitor changes in mental health attitudes outcomes following intervention programs to investigate stigmatic attitudes to mental health problems across different samples.

Effect of family stress on life satisfaction among female workers during the COVID-19 epidemic in China: Exploring the roles of anxiety symptoms and age

The study aimed to investigate the level of life satisfaction (LS) among Chinese female workers after resuming work during the COVID-19 epidemic, and to further explore the potential mediating and moderating roles in the association between family stress and LS. Self-reported questionnaires were completed by 10,175 participants. Results showed that the level of LS decreased. The family stress had a negative effect on LS, and the effect was mediated by anxiety symptoms. Additionally, age moderated the direct and indirect effects within this relationship. Interventions aiming to improve LS should consider these aspects and younger workers should be given special attention.

The Stigma and Self-Stigma Scales for attitudes to mental health problems: Psychometric properties and its relationship to mental health problems and absenteeism

The Stigma and Self-Stigma scales (SASS) measure multiple aspects of stigmatic beliefs about mental health problems, including cognitive aspects of stigma towards others (Stigma to Others) and emotional stigma toward others (Social Distance), anticipated stigma by others, self-stigma, avoidant coping strategies, and help-seeking intentions, alongside an index of social desirability. The properties of the SASS were investigated by employees of a large UK government organization. With minor exceptions, each of the SASS scales had strong psychometric properties, good internal reliability, and test-retest reliability. Social Distance, Anticipated Stigma, Self-Stigma, and Avoidant Coping were all strongly associated with a lack of help-seeking for mental health problems. Similarly, Stigma to Others, Self-Stigma, and Avoidant Coping were all associated with current mental health problems. Finally, absenteeism from the workplace was found to be negatively related to Stigma to Others, and positively related to Avoidant Coping and Anticipated Stigma. In conclusion, the SASS was able to measure several different forms of stigma about mental health simultaneously in people both with and without a history of mental health problems. The SASS can be used to monitor changes in mental health attitudes outcomes following intervention programs to investigate stigmatic attitudes to mental health problems across different samples.

Sickness absence due to common mental disorders in young employees in Sweden: are there differences in occupational class and employment sector?

BACKGROUND

A large proportion of sickness absence (SA) in young adults is due to common mental disorders (CMDs). Still studies on CMD-related SA in young workers are lacking, especially studies for those employed in the private sector. The current study investigated the associations between sector of employment, occupational class and SA due to CMDs. In addition, associations between type of employment branch and SA due CMDs within each sector were examined.

METHODS

This population-based longitudinal cohort study included 663,583 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 SA due to CMDs, between 2010 and 2016, were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using Cox regression analysis.

RESULTS

Sector of employment was associated with SA due to CMDs, such that public sector workers had an elevated risk when compared with private sector employees (adjusted HR: 1.31 (95% CI 1.29-1.33). Moreover, manual workers had a slightly elevated risk for SA due to CMDs compared to non-manual workers. Within the private sector, in both manual and non-manual workers, those employed in education and health and social services evidenced the highest rates and risks of SA due to CMDs.

CONCLUSION

Sector of employment and occupational class play a role in SA due to CMDs in young employees. These findings should be considered when identifying high-risk groups for SA in the young working population.

Psychotherapeutic Consultation Services in the Workplace: A Longitudinal Analysis of Treatments and Sick Leave Using Health Insurance Data

BACKGROUND

Psychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start.

METHODS

Routine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression.

RESULTS

Eighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences.

CONCLUSIONS

PSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed.

How Managers Find Out About Common Mental Disorders Among Their Employees

OBJECTIVE

To explore how managers find out about common mental disorders (CMDs) among employees and associations with managers' work- and knowledge-related characteristics and attitude to CMDs.

METHODS

Data from an online survey in 2017 with Swedish managers (n = 1810) were used. Different ways managers find out about CMDs were measured, and multivariate logistic regression analysis was conducted for associations with manager characteristics.

RESULTS

Few managers found out about CMDs themselves; another source was more common, for example, employees' self-disclosure. Managers' overseeing fewer subordinates and those with a negative attitude to depression were more likely to find out about CMDs themselves. The significance of mental health training and education could not be established.

CONCLUSION

Managers' awareness about employees' CMDs mainly came about through employees' self-disclosure. Managers' attitudes and work conditions were related to the way of finding out.

Prevalence and Associated Factors of Common Mental Disorders in Women: A Systematic Review

Objectives: To identify the prevalence and factors associated with common mental disorders in adult women. Methods: Searches were carried out in the PubMed, Web of Science, Science Direct, Scopus, Cinahl, Google Scholar and Open Gray databases. The study protocol was registered with PROSPERO under number CRD42020168231. Cross-sectional studies showing the prevalence of common mental disorders in women over 18 years were included. Studies with men, children and pregnant women of another age group and with other mental disorders and other types of studies were excluded. The Joanna Briggs Institute checklist was used to assess the risk of bias. Results: Nineteen studies were included in this review. The prevalence of CMD ranged from 9.6% to 69.3%. The main associated factors were unemployment, indebtedness, low income, being a housewife, smoking, low education, poor self-rated health, being single, divorced or widowed. The risk of bias in the studies was classified as low and moderate. Conclusion: This review revealed a variable prevalence rate of CMD in adult women. Public policies are needed to create strategies to prevent the mental illness of these women.

Frequent short sickness absence, occupational health service utilisation and long-term sickness absence due to mental disorders among young employees

Objectives

We examined whether frequent short-term sickness absence (FSTSA) and primary care use in occupational health service (OHS) were associated with medically-certified long-term sickness absence (LTSA) due to mental disorders among young employees.

Methods

We used record-linkage data covering the young employees (< 35 years) of the City of Helsinki, Finland (n = 8,282) from 2010 to 2014. The outcome was LTSA due to mental disorders. Cox regression models were fitted.

Results

FSTSAs were associated with subsequent LTSA. Also OHS use predicted LTSA due to mental disorders; however, this association was not found for those with prior FSTSA.

Conclusions

Both FSTSA and primary care use indicate subsequent LTSA independently, and together these indicators identify a larger proportion of individuals at risk of LTSA due to mental disorders.

Association of work performance and interoceptive awareness of 'body trusting' in an occupational setting: a cross-sectional study

OBJECTIVES

Work performance has been known to be influenced by both psychological stress (mind) and physical conditions (body). The aim of this study was to investigate the association between work performance and 'body trusting', which is a dimension of interoceptive awareness representing mind-body interactions.

METHODS

A cross-sectional study was conducted among a sample of workers in an industrial manufacturing company in Japan. Participants were assessed with a self-reported questionnaire including evaluations of work performance, body trusting, psychological distress, pain persistence, workplace and home stressors, and workaholism. Participants' sociodemographic, health and lifestyle characteristics were collected from their annual health check data. The association between work performance and body trusting was examined using multivariable regression analyses in the overall sample and in a subsample of people with pain.

RESULTS

A total of 349 workers participated in the study. A significant association between work performance and body trusting was observed, with higher body trusting representing higher work performance. The association was significant after controlling for psychological distress, workplace and home stress, workaholism and participants' characteristics (p<0.001). Compared with people without pain (n=126, 36.1%), people with pain (n=223, 63.9%) showed less body trusting, which was associated with decreased work performance after controlling for pain-related variables (p<0.001).

CONCLUSIONS

Workers with higher body trusting showed higher work performance, even after controlling for various influencing factors. Body trusting may be an important target to promote work performance and to prevent loss of performance induced by health problems.

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

OBJECTIVES

Depression symptoms are one of the most common psychiatric disorders and affect all aspects of life. The impact of depression symptoms on sick leave in the working population is a major issue that requires a more comprehensive examination.

METHODS

This systematic review used the PRISMA method to identify eligible studies (n = 15). Subsequently, the association between depression symptoms and sick leave was examined and several important subgroup analyses were performed.

RESULTS

Depression symptoms were associated with sick leave, with an overall risk ratio (RR) of 1.52 [95% confidence interval (95% CI) 1.34-1.73]. In men, the result displayed RR 2.19 (95% CI 1.17-4.09) and in women, the result showed RR 1.54 (95% CI 1.35-1.76). Additional subgroup analyses that account for methodological differences across studies based on the method of assessing depression symptoms and sick leave showed that this association was consistent.

CONCLUSION

Depression symptoms are associated with sick leave. Given that sick leave can have an economic and social burden, more attention to depression symptoms is necessary.

Work-unit social capital and incident purchase of psychotropic medications: A longitudinal cohort-study of healthcare workers

BACKGROUND

Whether workplace social capital affects employees' mental health is debated. We examined the association between work-unit aggregated social capital and incident purchase of psychotropic medications among employees.

METHODS

We used data from the WHALE (Well-being in Hospital Employees) cohort study. The study population comprised 21,711 employees without recent psychotropic purchase-history nested within 2283 work units in the Capital Region of Denmark. Employees were invited to participate in a survey in March 2014 (86% response). We assessed workplace social capital by eight items (covering trust/justice and collaboration) and aggregated the mean of responses up to each work unit and categorized the scores into quartiles. Data on psychotropic purchases (antidepressants and anxiolytics/hypnotics/sedatives) were extracted via linkage to national registers. Using two-level mixed-effects survival models, we analyzed the association between work-unit social capital and psychotropic purchases during a one-year follow-up period adjusting for individual-level workplace social capital.

RESULTS

Low work-unit social capital was associated with higher purchases of overall psychotropic medications in a dose-response manner (low-versus-high: HR=1.32, 95% CI=1.05-1.65), but this effect attenuated after adjusting for individual-level workplace social capital (HR=1.14, 95% CI=0.88-1.46). Low work-unit social capital was associated with higher purchases of antidepressants (HR=1.78, 95% CI=1.16-2.73) even after adjusting for individual-level workplace social capital (HR=1.69, 95% CI=1.05-2.73).

LIMITATIONS

Medical doctors/dentists were underrepresented in the data on workplace social capital.

CONCLUSIONS

Low work-unit social capital may be associated with higher use of antidepressants among healthcare employees. Interventions to improve social capital could potentially promote mental health at work in the healthcare setting.

Employment and earnings trajectories before and after sickness absence due to major depressive disorder: a nationwide case-control study

OBJECTIVES

To examine employment and earnings trajectories before and after the first sickness absence period due to major depressive disorder (MDD).

METHODS

All individuals (n=158 813) in Finland who had a first sickness absence period (lasting longer than 9 days) due to MDD between 2005 and 2015 were matched with one randomly selected individual of the same age and gender with no history of MDD. Employment status and earnings were measured using register-based data annually from 2005 to 2015. Generalised estimating equations were used to examine the trajectories of employment and earnings before and after MDD diagnosis in men and women separately.

RESULTS

Sickness absence due to MDD was associated with increased probability of non-employment during and after the year of the first sickness absence period. In men, but not in women, the probability of being employed was lower 5 years before the sickness absence period due to MDD. When compared with the individuals in the control group, men had around 34% and women 15% lower earnings 1 year, and 40% and 23%, respectively, 5 years, after the first sickness absence period due to MDD. More severe MDD and longer duration of sickness absence period were associated with lower probability of being employed.

CONCLUSIONS

Sickness absence due to MDD was associated with considerable reduction in employment and earnings losses. For men and individuals with more severe MDD, this reduction was before the first sickness period. This supports a reciprocal association between employment and earnings with MDD.

Is perceived safety and threat after workplace terrorism linked to employee sick-leave? A registry-based longitudinal study of governmental employees in Norway

BACKGROUND

A large body of research has shown that terrorism enhances fears and undermines perceived safety in a high proportion of both directly exposed individuals and individuals without any form of direct exposure (i.e. no geographical proximity to an attack). Some studies have further suggested that fear of terrorism may adversely affect health in those without direct exposure and that this may constitute an important public health burden because of the number who are indirectly exposed. Limited studies have investigated threat and safety perception after workplace terrorism and the possible consequences for employee health.

OBJECTIVE

To explore whether perceived safety and threat in employees whose workplace was subjected to a terrorist attack are associated with subsequent sick-leave.

METHOD

A longitudinal questionnaire survey on governmental employees' perceived safety and threat at work one (T1) and two (T2) years after the 2011 terrorist attack on the Norwegian ministries was linked to registry data on doctor-certified sick-leave for two 9-month periods following T1 and T2 (N = 1703).

RESULTS

There was fairly strong evidence (0.004 < p < 0.034) that higher perceived safety was associated with a close to 30% reduction in sick-leave in fully adjusted models which included terror exposure and symptom-based PTSD. There was inconclusive evidence that lower perceived threat was associated with reduced sick-leave in the full models.

CONCLUSIONS

Reduced perceived safety in employees following workplace terrorism may have adverse health consequences of public health significance given how prevalent this perception seems to be. The study supports that post-terrorism response plans should include strategies on how to address the potentially large number of individuals suffering ill health after terror even if they were not directly exposed and do not meet criteria for PTSD.

Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail)

Background

Common mental disorders are the leading cause of workplace absences. While the reasons for this are multifarious, there is little doubt that stigma related to common mental disorder plays a large role in sickness absence and in poor help-seeking. Frequently both managers and staff are unsure of how to approach and intervene with mental health related problems. We have therefore devised a mental health intervention programme (Prevail) that aims to reduce stigma and to educate staff about evidence-based low intensity psychological interventions. These can be used by the individual, as well as in collaboration with managers via co-production of problem-focussed solutions, with the aim of improving mental health, reducing sickness absence, and increasing workplace productivity.

Methods

This two-armed cluster randomised control trial (RCT) will evaluate the effectiveness of Prevail. Eighty managers at a large UK government institution (the DVLA) and their teams (approximately 960 employees) will be randomised into the active intervention group or control (employment as usual) arms of the study. All participants will be invited to complete a series of questionnaires related to mental health stigma, their current and past mental health, and their recent workplace productivity (absenteeism and presenteeism). All employees in the active arm will receive the Prevail Staff intervention, which covers stigma reduction and includes psychoeducation about evidence-based low intensity psychological interventions for common mental disorder. The managers in the active arm will also receive the Prevail Managers programme which covers communication skills, problem formulation, and problem-solving skills. The questionnaire battery will then be given to both groups again 4 weeks post training, and 12 months post-training. Official records of absenteeism from Human Resources will also be gathered from both active and control groups at 12 months post-training.

Discussion

The treatment trial aims to evaluate if Prevail reduces mental health related stigma (of a number of forms), increases help-seeking behaviours, and increases workplace productivity (via decreased absenteeism and presenteeism).

Trial registration

ISRCTN12040087. Retrospectively registered 04/05/2020.

Psychological distress and sickness absence: Within- versus between-individual analysis

BACKGROUND

Uncertainty remains whether associations for psychological distress and sickness absence (SA) observed between and within individuals differ, and whether age, gender and work-related factors moderate these associations.

METHODS

We analyzed SA records of 41,184 participants of the Finnish Public Sector study with repeated survey data between 2000 and 2016 (119,024 observations). Psychological distress was measured by the General Health Questionnaire (GHQ-12), while data on SA days were from the employers' registers. We used a hybrid regression estimation approach adjusting for time-variant confounders-age, marital status, occupational class, body mass index, job contract type, months worked in the follow-up year, job demand, job control, and workplace social capital-and time-invariant gender (for between-individual analysis).

RESULTS

Higher levels of psychological distress were consistently associated with SA, both within- and between-individuals. The within-individual association (incidence rate ratio (IRR) 1.68, 95% CI 1.61-1.75 for SA at high distress), however, was substantially smaller than the between-individual association (IRR 2.53, 95% CI 2.39-2.69). High levels of psychological distress had slightly stronger within-individual associations with SA among older (>45 years) than younger employees, lower than higher occupational class, and among men than women. None of the assessed work unit related factors (e.g. job demand, job control) were consistent moderators.

LIMITATIONS

These findings may not be generalizable to other working sectors or cultures with different SA policies or study populations that are male dominated.

CONCLUSIONS

Focus on within-individual variation over time provides more accurate estimates of the contribution of mental health to subsequent sickness absence.

Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment

BACKGROUND

Anxiety and depression are associated with substantial functional impairment. Prompt Mental Health Care (PMHC), the Norwegian adaptation of IAPT is currently piloted across Norway, as a means to improve access to evidence-based care for adults with anxiety disorders (including subthreshold cases) and minor to moderate depression. The aims of the current paper were to examine the change in work status and functional status from pre- to post-treatment and 12 months post-treatment among clients at the first 12 PMHC pilot sites, and whether degree of change differed across sociodemographic characteristics.

METHODS

A prospective cohort design was used, including working age clients receiving treatment between October 2014 and December 2016 (n = 1446, participation rate = 61%). Work status and functional status were self-reported, the latter by the Work and Social Adjustment Scale (WSAS). Changes in work status and WSAS score were examined through multilevel models based on maximum likelihood estimation. Likelihood ratio tests were performed to determine whether the interaction between time and the respective background variables were statistically significant.

RESULTS

A substantial increase in regular work participation was observed from pre- to post-treatment, which further had increased at 12 months post-treatment. The increase was driven by a corresponding reduction in proportion of clients working and receiving benefits (OR 0.38 [0.29-0.50] baseline to final treatment, OR = 0.19 [0.12-0.32] final treatment to 12-months post-treatment), while no statistically significant change was observed in proportion out of work. Large improvement (ES = - 0.89) in WSAS score was observed from pre- to post treatment. WSAS score at 12 months post-treatment remained at the post-treatment level.

CONCLUSIONS

Previous research has shown substantial symptom improvement among clients receiving treatment in PMHC. The current findings indicate that PMHC might also be able to aid adults struggling with mild to moderate anxiety and depression in returning to usual level of functioning. The degree to which the observed improvements are attributable to the treatment need nonetheless to be confirmed in a trial including a control group and with more complete follow-up data from registries.

Diagnosis-Specific Sickness Absence and Subsequent Common Mental Disorders: A Register-Linkage Cohort Study among Finnish Public Sector Employees

Sickness absence is associated with poor health outcomes, but little is known about its consequences for general mental health. This study examined the associations between diagnosis-specific sickness absence and subsequent common mental disorders (CMD). Register data on medically certified all-cause sickness absence and sickness absence due to mental disorders and musculoskeletal diseases from 2004-2007 were linked to the Helsinki Health Study 2007 and 2012 survey data on City of Helsinki employees in Finland (N = 3560). Using logistic regression and multinomial logistic regression, we analysed the associations between the total number of reimbursed sickness absence days in 2004-7 and CMD General Health Questionnaire 12) in 2007 and 2012 and CMD changes. Sickness absence due to mental disorders (age- and sex-adjusted odds ratio (OR)range: 2.16 to 2.93), musculoskeletal diseases (OR range: 2.79 to 2.93) and all-cause sickness absence (OR range: 1.48 to 3.20) were associated with CMD in 2007. In 2012, associations with lower ORs were observed. Associations were also found with changing and especially repeated (OR range: 1.49 to 3.40) CMD. The associations remained after adjusting for work-related covariates and health behaviours. Diagnosis-specific sickness absence showed persistent associations with subsequent CMD and their changes. Attention should be paid to both the short- and long-term consequences of sickness absence for employee mental health.

Satisfação no trabalho do pessoal de enfermagem na rede pública de saúde em uma capital brasileira

Resumo Evidências confirmam que a satisfação no trabalho percebida pelo pessoal da enfermagem está associada a indicadores de bem-estar dos profissionais e qualidade dos serviços prestados. O objetivo do estudo transversal foi investigar fatores associados com o relato de satisfação no trabalho. A satisfação no trabalho foi avaliada com base na pergunta já validada: “Você está satisfeito com o seu trabalho?”. A amostragem aleatória estratificada e proporcional incluiu enfermeiros, auxiliares e técnicos de enfermagem da rede municipal. O modelo multivariado foi baseado na técnica de regressão de Poisson com variâncias robustas para a estimação dos fatores independentemente associados com a satisfação no trabalho. Participaram 290 sujeitos: 73,8% relataram satisfação com o trabalho. Idade, contar com forte apoio social e melhores condições de trabalho foram positivamente associadas com satisfação. A triagem positiva para transtornos mentais comuns foi negativamente associada com satisfação. O destaque para o ambiente de trabalho e tipo de gestão indica a relevância desses fatores para o fortalecimento dos recursos humanos em saúde.

Factors Associated with Common Mental Disorders in Truck Drivers

Abstract This study aimed to identify the risk factors of Common Mental Disorders (CMD) using a sample of 565 Brazilian truck drivers. For data capture were applied the Self-Reporting Questionnaire (SRQ-20), Scale subscale of Psychosocial risks and questionnaire with socio-demographic, working and occupational stressors. The results obtained by multivariate binary logistic regression analysis, have explained the 39.9% of variation on CMD. The occupational stressor working hours is the predictor variable with highest impact, may implying in an increase of 5.41 times more chance of the trucker to present CMD. The results indicate actions by management level as work organization and public authorities with regard to the external work conditions.

A review of the economic impact of mental illness

Objective To examine the impact and cost associated with mental illness. Methods A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies. Results A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars). Conclusions Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions. What is known about the topic? Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy. What does this paper add? This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only limited information is available on the impact of attention deficit hyperactivity disorder, anxiety, cognitive function, conduct disorder, eating disorder and psychological distress. There was also a dearth of evidence on the intangible elements of pain and suffering of people and their families with depressive disorders. More research is required to better understand the full extent of the impact of mental illness and strategies that may be implemented to minimise this harm. What are the implications for practitioners? Knowing the current and future impact of mental illness highlights the imperative to develop an effective policy response.

[Prevalence of common mental disorders and associated factors in urban residents of São Paulo, Brazil]

Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association's significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.

Common Mental Disorders and Sickness Absence: A Register-Linkage Follow-Up Study Among Finnish Municipal Employees

OBJECTIVE

This study examined how common mental disorders (CMD) at different severity levels are associated with short (1 to 3-day), intermediate (4 to 14-day), and long (15+ day) sickness absence (SA) among Finnish municipal employees.

METHODS

Survey data collected among the 40 to 60-year-old employees of the City of Helsinki in 2000 to 2002 were prospectively linked with employer's SA register data (N = 6554). Associations of CMD (GHQ-12) with SA in a 5-year follow-up were examined with quasi-Poisson regression.

RESULTS

Increasing GHQ-12 scores were associated with a higher number of SA spells. The highest GHQ-12 scores were associated with the highest number of short, intermediate, and long SA spells. Adjusting for social and health-related covariates attenuated the associations but they remained.

CONCLUSION

Increasing severity of CMD increased the risk of short, intermediate, and long SA among Finnish employees. CMD should be tackled to prevent SA and promote work-ability among aging employees.

What are they returning to? Psychosocial work environment as a predictor of returning to work among employees in treatment for common mental disorders: A prospective observational pre-post study

INTRODUCTION

Long-term sick leave and disabilities due to common mental disorders are challenging for society, employers, and individuals. Hence, we wanted to investigate whether psychosocial work environments experienced by employees undergoing treatment for such disorders was associated with return to work.

METHODS

At the start of treatment, 164 patients responded to questionnaires concerning their psychosocial work environment (the Job Demand-Control-Support model and the Effort-Reward Imbalance model), symptoms (The Clinical Outcomes in Routine Evaluation Outcome Measure) and ability to work (Work Ability Index). In addition, the respondents reported whether they were working or on sick leave at the start and end of their courses of treatment. Their therapists provided information about diagnoses.

RESULTS

Return to work was associated with control of decisions, support from colleagues, esteem, and job promotion opportunities as measured at the start of treatment. In multivariate analyses, control over decisions and job promotion opportunities continued to predict return to work when adjusted for symptoms, current work ability, and expected future work ability.

DISCUSSION

The working conditions that predicted return to work are considered to facilitate work performance and to be sources of motivation, job satisfaction, and job commitment. Consequently, it is important to examine whether this patient group has a favorable working environment and consider changes in the workplace if the environment is not favorable.

Predictive factors of the duration of sick leave due to mental disorders

Background

This study aimed to examine potential predictors of duration of sick leave due to mental disorders in Japan.

Methods

A total of 207 employees at a manufacturing company in Japan with a past history of sick leave due to mental disorders participated in this study. Mental disorders were defined as those listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). All of the participants used the mental health program that the company provided. The predictive power of the variables was tested using a Cox proportional hazard analysis. The hazard ratios in the final model were used to identify the predictor variables of the duration of sick leave. We included socio-demographic (age, sex, tenure), clinical (diagnosis and number of previous sick leave), and work-related factors (employment rank) as possible predictors. Data on these variables were obtained through the psychiatrists and psychologists in the company’s mental health program.

Results

The results of the univariate analyses showed that the number of previous sick leave episodes, diagnosis and employee rank were significant predictors of the duration of sick leave due to mental disorders. A multivariate analysis indicated that age, number of previous sick leave and employee rank were statistically significant predictors of return to work.

Conclusions

Diagnosis, number of previous sick leave episodes, and employee rank are predictors of the duration of sick leave due to mental disorders. This study’s findings have implications in the development of effective interventions to prevent protracted sick leave.

Exposure to work stress and use of psychotropic medications: a systematic review and meta-analysis

BACKGROUND

There is good evidence that job stressors are prospectively related to mental health problems, particularly depressive symptoms. This review aimed to examine whether job stressors were also related to use of psychotropic medications.

METHODS

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we examined seven electronic databases that indexed literature from a wide range of disciplines. Inclusion criteria were (1) the study included a job stressor or psychosocial working condition as an exposure, and (2) psychotropic medication was an outcome. All effect-size estimates were considered but needed to present either a SE or 95% CIs to be included in meta-analyses. Data were pooled between studies using the relative risk (RR) or odds ratio (OR) and 95% CIs.

RESULTS

There were 18 unique studies with non-overlapping exposures eligible for inclusion in the quantitative meta-analysis. High job demands were associated with a statistically significant increased risk of psychotropic medication use (RR 1.16, 95% CI 1.02 to 1.31). There was also an elevated RR in relation to work-family conflict (RR 1.26, 95% CI 1.03 to 1.48). In studies reporting OR, high job demands were associated with an OR of 1.39 (95% CI 1.06 to 1.71).

CONCLUSIONS

The findings of this review highlight the need for policy and programme attention to reduce harmful exposure to psychosocial job stressors. Health-service use measures should be considered as outcomes and may represent more severe mental health conditions.

Changes in common mental disorders and diagnosis-specific sickness absence: a register-linkage follow-up study among Finnish municipal employees

OBJECTIVE

This study examined the associations between changes in common mental disorders (CMD) and subsequent diagnosis-specific sickness absence (SA) among midlife and ageing municipal employees.

METHODS

Data from the Helsinki Health Study phase I (2000-2002) and phase II (2007) surveys among employees of the City of Helsinki, Finland, were linked with prospective register data from the Social Insurance Institution of Finland on diagnosis-specific (mental, musculoskeletal, other causes) SA (n=3890). Associations between change in CMD (General Health Questionnaire 12) from phase I to phase II and the first SA event in 2007-2014 were analysed using Cox regression modelling. Sociodemographic, work and health-related covariates from phase I, and SA from the year preceding phase I were controlled for.

RESULTS

Having CMD at one or two time points, that is, favourable and unfavourable change in CMD and repeated CMD, were all associated with a higher risk of SA due to mental, musculoskeletal and other diagnoses compared with women and men with no CMD. Favourable change in CMD reduced the risk of SA when compared with repeated CMD. The strongest associations were observed for repeated CMD (HR range: 1.44 to 5.05), and for SA due to mental diagnoses (HR range: 1.15 to 5.05). The associations remained after adjusting for the covariates.

CONCLUSIONS

Changing and repeated CMD increased the risk of SA due to mental, musculoskeletal and other diagnoses. CMD should be tackled to prevent SA and promote work-ability among ageing employees.

Mental disorder sick leave in Sweden: A population study

BACKGROUND

The inability to perform productive work due to mental disorders is a growing concern in advanced societies.

OBJECTIVE

To investigate medically certified mental disorder and all-cause sick leave in a working population using demographic, socioeconomic and occupational predictors.

METHODS

The study population was the entire Swedish work force aged 16-64 years in December 31st 2011. The outcome was sick leave exceeding 14 days in 2012 with adjustment for 13 confounders.

RESULTS

The risk of sick leave with a mental disorder is higher among women compared to men, among persons aged 30-39 and among parents in families with underage children. Employees in welfare service occupations within health care, education and social services have an elevated risk of mental disorder sick leave and constitute a large proportion of the workforce.

CONCLUSION

The results support the need for improving early detection and prevention of mental disorders in the workforce. Improvements in psychosocial work environments are essential, where the higher risk in female dominated welfare occupations particularly, have repercussions on the quality of the welfare services provided for vulnerable groups in society. Better work-life balance in families with younger children could also mitigate the effects of a high total workload in that particular phase of life.

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.

Satisfaction with life and the risk of occupational injury

Background

Occupational injuries increase burden on society as well as personal health. Low satisfaction with life may not only increases the risk of occupational injuries directly, but also influences other factors that increase the risk of occupational injury. Along with previous studies on the risk of occupational injury, we sought to explore the relationship between satisfaction with life and occupational injury.

Methods

The study participants were 6234workers health screened at a university hospital in Incheon. Information on occupational injury and satisfaction with life scale (SWLS) was obtained in a self-report format. Participants were allocated to one of four SWLS groups; the dissatisfied group, the slightly dissatisfied group, the slightly satisfied group, and the satisfied group. The analysis was performed using the chi-square test primarily and by logistic regression adjusted for potential confounders.

Results

In men, the un-adjusted and adjusted odds ratios (ORs) of low satisfaction with life (SWLS< 20) were 1.98(CI1.55-2.53) and 1.81(CI 1.41-2.32), respectively. When the SWLS were divided into four groups, the adjusted ORs of the slightly satisfied (20-25), slightly dissatisfied(15-19), and dissatisfied(≤14) groups were 1.21, 1.72, and 2.70, respectively. That is ORs tended to increase linearly with decreasing SWLS score (p for trend < 0.001). In women, this relation was of borderline significance at best.When subjects were dichotomized based on SWLS scores, for males, the cured and adjusted RRs of occupational injury in the low satisfaction with life group were1.91 (95% CI: 1.50-2.42) and 1.66 (95% CI: 1.30-2.13), and for females, the adjusted-RR was marginally significant (1.67; 95% CI: 0.93-2.99).When subjects were divided into four groups by SWLS scores, adjusted RRs tended to increase linearly with decreasing SWLS score for males (slightly satisfied: 1.18, 95% CI: 0.77-1.82; slightly dissatisfied: 1.65, 95% CI: 1.08-2.52; dissatisfied: 2.22, 95% CI: 1.44-3.42; p for trend < 0.001) and for females (slightly satisfied: 1.17, 95% CI: 0.42-3.30; slightly dissatisfied: 1.56, 95% CI: 0.56-4.36; dissatisfied: 2.38, 95% CI: 0.84-6.74; p for trend = 0.040).

Conclusions

This study suggests that the risk of occupational injury was higher in workers not satisfied with life, and indicates attention to satisfaction with life may promote the health of workers.

Depressive symptoms and risk of absence among workers in a manufacturing company: a 12-month follow-up study

Depression is a leading cause of reduced work ability and absence due to sickness. The objective of this study was to investigate how depressive symptoms are prospectively associated with subsequent absence, whether caused by illness or accidents, among manufacturing workers. This prospective study was conducted on 2,349 male and female employees that underwent a regular health examination at a university hospital. Depressive symptoms were measured at baseline using the Center for Epidemiologic Studies Depression (CES-D) Scale. Data on self-reported absence due to illness and accidents were obtained during a follow up of 1 yr. The incidences of sickness absence were 6.0% for men and 17.3% for women. Men and women with depressive symptoms (CES-D ≥16) were found to have higher odds of sickness absence during follow up (men: OR=4.06; 95% CI: 2.32-7.11; women: OR=1.75; 95% CI: 1.02-2.98), after adjustment for demographic and occupational factors. When depressive symptoms were divided into quartiles, significantly higher ORs of sickness absence were observed only among employees with the highest quartile of depressive symptoms. The study shows that depressive symptoms are a risk factor for future absence due to illness or accidents among manufacturing workers.

Preventing Sickness Absence With Career Management Intervention: A Randomized Controlled Field Trial

This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence.

Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a randomized controlled trial. Sickness absence data were collected covering a period from 1 year before (baseline) to approximately 2 years after the intervention (follow-up). The data were analyzed using zero-inflated negative binomial models.

After controlling for baseline absence, age, gender, and organization, the intervention was effective in decreasing the number of longer sickness absences (lasting longer than > 2 weeks), but no other significant effects were found.

These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations.

The Impact of Depression on Ill-Health Retirement and Its Moderating Factors: Analysis From the Korean Longitudinal Study of Aging (2006 to 2014)

OBJECTIVE

To investigate the effect of depressive symptoms on ill-health retirement (IHR).

METHODS

Data were collected from the Korean Longitudinal Study of Ageing which conducted biennially from 2006 to 2014. IHR were defined as those who retired due to their health problems. The short-form Center for Epidemiological Studies-Depression scale served as outcome measure for definition of depressive symptoms. Hazard ratios of IHR were estimated by Cox regression.

RESULTS

We observed that depressive symptoms significantly increased risk of IHR during 8-year follow-up period. Compared with those without depressive symptoms, depressed worker had 1.27-fold elevated risk for IHR. Subgroup analysis showed that the association between depressive symptoms and IHR is greater in the elders, women, and lower income group than the others.

CONCLUSION

Depressive symptoms independently predicted IHR. Moreover, age, sex, and socioeconomic status modified these effects.

Epidemiological profile of public servants absent from work due to mental disorders from 2010 to 2013

Objective

Describe the epidemiological profile of mental and behavior disorders (MBD) of public servants in the State of Santa Catarina, which resulted in workers providing medical certificates, between 2010 and 2013.

Method

A descriptive cross-sectional study with a quantitative approach, performed from data provided by the State Secretary of Administration. All medical certificates classified as in Chapter V of ICD-10 - Group "F" - Mental and Behavioral Disorders (MBD) were considered for analysis in the period.

Results

The study included 71 state agencies, primarily the State Secretary of Education, which corresponds to about 46% of all workers. Considering all the pathologies, 79,306 medical certificates were registered, among which, 40.14% were for MDB. Of the 8,765 workers with medical certificated for MBD, significant differences were found in the prevalence of work absence between gender (more women, in general, with the exception of MBD caused by psychoactive substance use), levels of education, city of the working place, government agency of work, and workers job position.

Analysis of managerial and healthcare indicators after nursing personnel upsizing

OBJECTIVE

analyze healthcare and managerial indicators after nursing personnel upsizing.

METHOD

a retrospective, descriptive study was conducted using data from computer systems of a university hospital in southern Brazil. Healthcare and managerial indicators related to the first half of 2013 and 2014 were statistically analyzed.

RESULTS

increases of 40.0% in the number of nurses and 16.0% in the number of nursing technicians led to reductions of 12.0% in the number of sickness absences, 21.8% in positive balance for compensatory time off, 92.0% in paid overtime. Reductions of 75.0% in pressure ulcer rates, 10.5% in the number of falls and 50.0% in infections due to indwelling catheter use were also observed.

CONCLUSION

nursing staff upsizing caused a positive impact on managerial and healthcare indicators and helped qualify care and improve work conditions for the nursing team.

Working in dissonance: experiences of work instability in workers with common mental disorders

BACKGROUND

Common mental disorders have a negative impact on work functioning, but less is known about the process when the functioning starts to destabilize. This study explores experiences of work instability in workers with common mental disorders.

METHODS

A grounded theory study using a theoretical sampling frame, individual in-depth interviews and a constant comparative analysis conducted by a multidisciplinary research team. The sample involved 27 workers with common mental disorders, currently working full or part time, or being on sick leave not more than 6 months. They were women and men of different ages, representing different occupations and illness severity.

RESULTS

A general process of work instability was conceptualized by the core category Working in dissonance: captured in a bubble inside the work stream. The workers described that their ordinary fluency at work was disturbed. They distanced themselves from other people at and outside work, which helped them to regain their flow but simultaneously made them feel isolated. Four categories described sub-processes of the dissonance: Working out of rhythm, Working in discomfort, Working disconnected and Working in a no man's land.

CONCLUSIONS

The experience of work instability in CMDs was conceptualized as "working in dissonance", suggesting a multifaceted dissonance at work, characterized by a sense of being caught up, as if in a bubble. Focusing on how the worker can re-enter their flow at work when experiencing dissonance is a new approach to explore in occupational and clinical settings.

Mental symptoms and cause-specific mortality among midlife employees

BACKGROUND

Mental symptoms are prevalent among populations, but their associations with premature mortality are inadequately understood. We examined whether mental symptoms contribute to cause-specific mortality among midlife employees, while considering key covariates.

METHODS

Baseline mail survey data from 2000-02 included employees, aged 40-60, of the City of Helsinki, Finland (n = 8960, 80 % women, response rate 67 %). Mental symptoms were measured by the General Health Questionnaire 12-item version (GHQ-12) and the Short Form 36 mental component summary (MCS). Covariates included sex, marital status, social support, health behaviours, occupational social class and limiting long-standing illness. Causes of death by the end of 2013 were obtained from Statistics Finland (n = 242) and linked individually to survey data pending consent (n = 6605). Hazard ratios (HR) and 95 % confidence intervals (95 % CI) were calculated using Cox regression analysis.

RESULTS

For all-cause mortality, only MCS showed a weak association before adjustments. For natural mortality, no associations were found. For unnatural mortality (n = 21), there was a sex adjusted association with GHQ (HR = 1.96, 95 % CI = 1.45-2.64) and MCS (2.30, 95 % CI = 1.72-3.08). Among unnatural causes of death suicidal mortality (n = 11) was associated with both GHQ (2.20, 95 % CI = 1.47-3.29) and MCS (2.68, 95 % CI = 1.80-3.99). Of the covariates limiting long-standing illness modestly attenuated the associations.

CONCLUSIONS

Two established measures of mental symptoms, i.e. GHQ-12 and SF-36 MCS, were both associated with subsequent unnatural, i.e. accidental and violent, as well as suicidal mortality. No associations were found for natural mortality due to diseases. These findings need to be corroborated in further populations. Supporting mental health through workplace measures may help counteract subsequent suicidal and other unnatural mortality among midlife employees.

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.

Mental health symptoms identify workers at risk of long-term sickness absence due to mental disorders: prospective cohort study with 2-year follow-up

Background

Mental health problems are a leading cause of long-term sickness absence (LTSA). Workers at risk of mental LTSA should preferably be identified before they report sick. The objective of this study was to examine mental health symptoms as predictors of future mental LTSA in non-sicklisted workers.

Methods

Prospective cohort study of 4877 non-sicklisted postal workers. Mental health symptoms were measured at baseline in November 2010 with the Four-Dimensional Symptom Questionnaire (distress and depressed mood) and Maslach’s Burnout Inventory (fatigue). Mental health symptom scores were analyzed against incident mental LTSA retrieved from an occupational health register in 2011 and 2012. The area under the receiver operating characteristic curve (AUC) represented the ability of mental health symptom scores to discriminate between workers with and without mental LTSA during 2-year follow-up.

Results

Complete cases analysis included 2782 (57 %) postal workers of whom 73 had mental LTSA during 2-year follow-up. Distress fairly (AUC = 0.75; 95 % CI 0.67–0.82) and both depressed mood (AUC = 0.64; 95 % CI 0.57–0.72) and fatigue (AUC = 0.61; 95 % CI 0.53–0.69) poorly discriminated between workers with and without mental LTSA during 2-year follow-up. The discriminative ability of distress did not improve by adding depressed mood and fatigue.

Conclusions

Measurement of distress sufficed to identify non-sicklisted postal workers at risk of future mental LTSA. The Four-Dimensional Symptom Questionnaire distress scale is a promising tool to screen working populations for of mental LTSA, which enables secondary preventive strategies.