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Mulder M, Kok R, Aben B, de Wind A. Incidence Rates and Predictors of Recurrent Long-Term Mental Sickness Absence Due to Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10226-7. [PMID: 39066861 DOI: 10.1007/s10926-024-10226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Several predictors have been identified for mental sickness absence, but those for recurrences are not well-understood. This study assesses recurrence rates for long-term mental sickness absence (LTMSA) within subgroups of common mental disorders (CMDs) and identifies predictors of recurrent LTMSA. METHODS This historical prospective cohort study used routinely collected data from 16,310 employees obtained from a nationally operating Dutch occupational health service (ArboNed). Total follow-up duration was 23,334 person-years. Overall recurrence rates were assessed using Kaplan-Meier estimators. Recurrence rates within subgroups of CMDs were calculated using person-years. Univariable and multivariable Cox proportional hazards models were used to identify predictors. RESULTS 15.6% of employees experienced a recurrent LTMSA episode within three years after fully returning to work after a previous LTMSA episode. Highest recurrence rates for LTMSA were observed after a previous LTMSA episode due to mood or anxiety disorders. Mood or anxiety disorders and shorter previous episode duration were predictors of recurrent LTMSA. No associations were found for age, gender, company size, full-time equivalent and job tenure. CONCLUSION Employees should be monitored adequately after they fully returned to work after LTMSA. It is recommended to monitor high-risk employees (i.e. employees with mood or anxiety disorders and short LTMSA episode) more intensively, also beyond full return to work. Moreover, diagnosis of anxiety and depressive symptoms should be given a higher priority in occupational healthcare.
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Affiliation(s)
- Matthew Mulder
- Department of Research and Development, HumanTotalCare B.V., Zwarte Woud 10, Utrecht, 3524 SJ, The Netherlands.
| | - Robin Kok
- Department of Research and Development, HumanTotalCare B.V., Zwarte Woud 10, Utrecht, 3524 SJ, The Netherlands
| | - Bart Aben
- Department of Research and Development, HumanTotalCare B.V., Zwarte Woud 10, Utrecht, 3524 SJ, The Netherlands
| | - Astrid de Wind
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, The Netherlands
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In't Hout L, van Hees SGM, Vossen E, Oomens S, van de Mheen D, Blonk RWB. Factors Related to the Recurrence of Sickness Absence Due to Common Mental Health Disorders: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10224-9. [PMID: 38985239 DOI: 10.1007/s10926-024-10224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE Employees who experience sickness absence (SA) due to common mental disorders (CMD) are at increased risk of recurrent sickness absence (RSA). This systematic literature review examines the factors at different levels in the work and non-work context that increase or decrease the likelihood of RSA due to CMD. The resulting knowledge enables more accurate identification of employees at risk of RSA. METHODS We conducted a search in June 2023 using the following databases: PubMed, PsycInfo, Web of Science, Cumulative Index to Nursing & Allied Health Literature (Cinahl), Embase and Business Source Ultimate (BSU). Inclusion criteria were as follows: (self-)employees, CMD, related factors, RSA. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Individual, Group, Leader, Organisation and Overarching/social context (IGLOO) model were used to cluster the found factors and these factors were graded by evidence grading. RESULTS Nineteen quantitative and one qualitative studies of mainly high and some moderate quality were included in this review. A total of 78 factors were found. These factors were grouped according to the IGLOO levels and merged in 17 key factors. After evidence grading, we found that mainly low socioeconomic status (SES) and the type of previous SA (short-term SA and SA due to CMD) are predictors of an increased risk of RSA. CONCLUSIONS Having a low SES and previous experience of SA (short term, or due to CMD) are factors that predict the chance of RSA, implying the need for prolonged support from occupational health professionals after the employee has returned to work.
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Affiliation(s)
- Lydia In't Hout
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | - Suzanne G M van Hees
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Emma Vossen
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Shirley Oomens
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboudumc, Nijmegen School of Occupational Health, Nijmegen, The Netherlands
| | - Dike van de Mheen
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Roland W B Blonk
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Science, Tilburg University, Tilburg, The Netherlands
- Optentia, North-West University, Vanderbijlpark, South Africa
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Etuknwa A, Daniels K, Nayani R, Eib C. Sustainable Return to Work for Workers with Mental Health and Musculoskeletal Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1057. [PMID: 36673814 PMCID: PMC9859362 DOI: 10.3390/ijerph20021057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Common mental health and musculoskeletal disorders (CMDs and MSDs) are two of the most significant causes of non-participation in employment amongst working age adults. BACKGROUND This case study fills an important gap in the scientific literature on reintegration back to work after sickness absence due to CMDs and MSDs. It particularly examines the return to work (RTW) experiences of sick-listed employees to understand the facilitators and barriers of sustainable RTW. METHODS Using a realist evaluation approach within a qualitative inquiry, perceptions of employees were explored to provide in-depth understanding of what, how and under what circumstances sustainable RTW can be enabled for employees absent on a short- or long-term basis. Repeat face-to-face semi-structured interviews were conducted with 22 participants (15 women and 7 men, aged 30-50 years and sick-listed with MSDs and CMDs) who were recruited using purposive sampling. Data was thematically analysed. RESULTS A total of 2 main codes and 5 subcodes were developed and grouped into three theoretical abstractions. As a result of validating the context, mechanism, and outcome configurations with accounts of participants, all three initial theories explaining the most prominent mechanisms that either facilitates or impedes a sustainable RTW for people with CMDs and MSDs were justified. CONCLUSIONS Our findings reveal the active role of line managers on the RTW outcomes of returning employees. However, line-manager's competence and ability to effectively support and implement appropriate RTW strategies suited to employees' hinges on working in alignment with key stakeholders and returning employees.
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Affiliation(s)
| | - Kevin Daniels
- Norwich Research Park, Norwich Business School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Rachel Nayani
- Norwich Research Park, Norwich Business School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Constanze Eib
- Department of Psychology, Uppsala University, 752 36 Uppsala, Sweden
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Morgan MA, Kelber MS, Bellanti DM, Beech EH, Boyd C, Galloway L, Ojha S, Garvey Wilson AL, Otto J, Belsher BE. Outcomes and prognosis of adjustment disorder in adults: A systematic review. J Psychiatr Res 2022; 156:498-510. [PMID: 36347110 DOI: 10.1016/j.jpsychires.2022.10.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Adjustment disorder (AD) is one of the most commonly diagnosed mental health disorders and is generally conceptualized to be mild and short-lived. Despite the frequent use of AD in clinical settings, little is known about the prognosis of this condition. Our goal was to systematically review research on a range of AD outcomes in order to provide a broad characterization of AD prognosis. We conducted searches in MEDLINE, EMBASE, and PsycINFO. We included 31 cohort or randomized controlled trials with a total of 1,385,358 participants. Many patients maintained an AD diagnosis or were diagnosed with another mental health disorder months to years after initial diagnosis. Patients with AD tended to show symptom improvement at higher rates and to utilize less treatment than did patients with other disorders. AD-diagnosed groups experienced subsequent development of numerous physical conditions, such as infection, cancers, Parkinson's disease, and cardiovascular events, at higher rates than did control groups. Results were mixed regarding suicidality and occupational impairment. We rated most studies as having a moderate risk of bias. Based on limited findings, AD appears to progress as a milder disorder than do other disorders, but it not uncommonly transitions to more severe mental health states and may predict the development of future health issues, both mental and physical. Future prospective research that conforms to prognosis study guidelines is needed to better understand the course of this common disorder.
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Affiliation(s)
- Maria A Morgan
- Psychological Health Center of Excellence, Defense Health Agency, USA.
| | | | - Dawn M Bellanti
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Erin H Beech
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Courtney Boyd
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Lindsay Galloway
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Suman Ojha
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Abigail L Garvey Wilson
- Psychological Health Center of Excellence, Defense Health Agency, USA; Department of Epidemiology, George Washington University, Washington, DC, USA
| | - Jean Otto
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Bradley E Belsher
- Psychological Health Center of Excellence, Defense Health Agency, USA; Phoenix VA Health Care System, Carl T. Hayden Veterans Medical Center, Phoenix, AZ, USA
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Dorrington S, Carr E, Stevelink SAM, Dregan A, Woodhead C, Das-Munshi J, Ashworth M, Broadbent M, Madan I, Hatch SL, Hotopf M. Multimorbidity and fit note receipt in working-age adults with long-term health conditions. Psychol Med 2022; 52:1156-1165. [PMID: 32895068 DOI: 10.1017/s0033291720002937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Research on sickness absence has typically focussed on single diagnoses, despite increasing recognition that long-term health conditions are highly multimorbid and clusters comprising coexisting mental and physical conditions are associated with poorer clinical and functional outcomes. The digitisation of sickness certification in the UK offers an opportunity to address sickness absence in a large primary care population. METHODS Lambeth Datanet is a primary care database which collects individual-level data on general practitioner consultations, prescriptions, Quality and Outcomes Framework diagnostic data, sickness certification (fit note receipt) and demographic information (including age, gender, self-identified ethnicity, and truncated postcode). We analysed 326 415 people's records covering a 40-month period from January 2014 to April 2017. RESULTS We found significant variation in multimorbidity by demographic variables, most notably by self-defined ethnicity. Multimorbid health conditions were associated with increased fit note receipt. Comorbid depression had the largest impact on first fit note receipt, more than any other comorbid diagnoses. Highest rates of first fit note receipt after adjustment for demographics were for comorbid epilepsy and rheumatoid arthritis (HR 4.69; 95% CI 1.73-12.68), followed by epilepsy and depression (HR 4.19; 95% CI 3.60-4.87), chronic pain and depression (HR 4.14; 95% CI 3.69-4.65), cardiac condition and depression (HR 4.08; 95% CI 3.36-4.95). CONCLUSIONS Our results show striking variation in multimorbid conditions by gender, deprivation and ethnicity, and highlight the importance of multimorbidity, in particular comorbid depression, as a leading cause of disability among working-age adults.
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Affiliation(s)
- Sarah Dorrington
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ewan Carr
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Sharon A M Stevelink
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
- King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alex Dregan
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Charlotte Woodhead
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Jayati Das-Munshi
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Mark Ashworth
- School of Population Health and Environmental Sciences, King's College London, Guy's Campus, Addison House, London SE1 1UL, UK
| | | | - Ira Madan
- Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Stephani L Hatch
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology & Neuroscience King's College London, 16 De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Transtornos mentais comuns em profissionais de enfermagem de serviços de emergência. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao03032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Work Resumption after a Fixed-Term Disability Pension: Changes over Time during a Period of Decreasing Incidence of Disability Retirement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094618. [PMID: 33925338 PMCID: PMC8123680 DOI: 10.3390/ijerph18094618] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 01/27/2023]
Abstract
The incidence of disability retirement in Finland has sharply decreased over the last ten years. At the same time, the share of fixed-term pensions has increased to cover more than half of all new disability pensions. This study examined the efficiency of fixed-term disability pensions under these changing circumstances with the aim of addressing the following research questions: are fixed-term disability pensions more often converted to permanent pensions, and how have the changes affected return to work? The study was based on register data of Finnish residents aged 25-62 whose fixed-term disability pension started in 2006 (n = 10,177) or 2015 (n = 7918). Of the fixed-term disability pensions starting in 2006, 58 percent were converted to a permanent disability pension within the next four years. In 2015, the corresponding figure was 41 percent. Return to work increased from 24 to 30 percent. In addition, ending up in some other state (most often unemployment) increased, and, more often, fixed-term disability pensions continued for more than four years. Transferring to a permanent disability pension decreased more among the younger, those with a lower education, and those suffering from mental disorders. The results were not notably affected by changes in the characteristics of fixed-term disability pension recipients (e.g., demographic and occupational characteristics and rehabilitation) or the selection of applicants into a fixed-term or a permanent pension. Return to work increased more among men, the older age groups, those with a fixed-term disability pension due to somatic diseases, and those who had received vocational rehabilitation. Adjusting for the composition of fixed-term disability pensioners increased the differences between the study years, and controlling for the selection into a fixed-term pension further widened the differences. In conclusion, a decreasing proportion of fixed-term disability pensions are converted to permanent pensions, but this is only partly reflected in increased return to work. Further efforts are needed to support work resumption after a fixed-term disability pension to avoid the situation where people drop out from disability pension but are resting on unemployment and other benefits.
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Lidwall U. Gender composition in occupations and branches and medically certified sick leave: a prospective population study. Int Arch Occup Environ Health 2021; 94:1659-1670. [PMID: 33779781 PMCID: PMC8384792 DOI: 10.1007/s00420-021-01672-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/14/2021] [Indexed: 12/03/2022]
Abstract
Objective To investigate whether gender-segregated occupations and branches are associated with future medically certified sick leave for women and men. Methods All gainfully employed residents in Sweden in December 31st 2014 aged 16–69 years (n = 4 473 964) were identified in national registers. Subjects working in segregated (61–90%) and extremely segregated (> 90%) occupations and branches were evaluated v/s subjects in gender-integrated occupations and branches (40–60%). Combinations of segregation by occupation and branch were also investigated. Two-year prospective medically certified sick leaves (> 14 days) were evaluated using logistic regression with odds ratios recalculated to relative risks (RR), adjusted for work, demographic and health related factors. Results The sick leave risk was higher for those working in extremely female-dominated occupations (women RR 1.06 and men RR 1.13), and in extremely female-dominated branches (women RR 1.09 and men RR 1.12), and for men in extremely male-dominated branches (RR 1.04). The sick leave risk was also higher for both women and men in female-dominated occupations regardless of the gender segregation in the branch they were working in. However, the differences in sick leave risks associated with gender segregation were considerably smaller than the differences between occupations and branches in general. Conclusions Gender segregation in occupations and branches play a role for sick leave among women and men, especially within extremely female-dominated occupations and branches. However, gender segregation appears to be subordinate to particular occupational hazards faced in diverse occupations and branches.
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Affiliation(s)
- Ulrik Lidwall
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,Statistical Analysis Unit, Department for Analysis and Forecast, Swedish Social Insurance Agency, 103 51, Stockholm, Sweden.
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Gaspar FW, Wizner K, Morrison J, Dewa CS. The influence of antidepressant and psychotherapy treatment adherence on future work leaves for patients with major depressive disorder. BMC Psychiatry 2020; 20:320. [PMID: 32560678 PMCID: PMC7304154 DOI: 10.1186/s12888-020-02731-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 06/12/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Depression is the greatest contributor to worldwide disability. The purpose of this study was to understand the influence of antidepressant and psychotherapy treatment adherence on future work leaves for patients with major depressive disorder. METHODS Patients with a newly diagnosed major depressive disorder (n = 26,256) were identified in IBM® Watson™ MarketScan® medical and disability claims databases. Antidepressant and psychotherapy adherence metrics were evaluated in the acute phase of treatment, defined as the 114 days following the depression diagnosis. Multiple variable Cox proportional hazards regression models evaluated the influence of antidepressant and/or psychotherapy adherence on future injury or illness work leaves. RESULTS The majority of work leaves in the 2-year follow-up period occurred in the acute phase of treatment (71.2%). Among patients without a work leave in the acute phase and who received antidepressants and/or psychotherapy (n = 19,994), those who were adherent to antidepressant or psychotherapy treatment in the acute phase had a 16% (HR = 0.84, 95% CI = 0.77-0.91) reduced risk of a future work leave compared to treatment non-adherent patients. Patients who were non-adherent or adherent to antidepressant treatment had a 22% (HR = 1.22, 95% CI = 1.11-1.35) and 13% (HR = 1.13, 95% CI = 1.01-1.27) greater risk of a future work leave, respectively, than patients not receiving antidepressant treatment. Conversely, patients who were non-adherent or adherent to psychotherapy treatment had a 9% (HR = 0.91, 95% CI = 0.81-1.02) and 28% (HR = 0.72, 95% CI = 0.64-0.82) reduced risk of a future work leave, respectively, than patients not receiving psychotherapy treatment. CONCLUSIONS This analysis suggests that treatment adherence may reduce the likelihood of a future work leave for patients with newly diagnosed major depressive disorder. Psychotherapy appears more effective than antidepressants in reducing the risk of a future work leave.
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Affiliation(s)
| | - Kerri Wizner
- MDGuidelines, ReedGroup Ltd., Westminster, CO USA
| | | | - Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Davis, California USA
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