Abstract
Background
Over the last decade sickness absence and disability pension (DP) due to psychiatric disorders have increased considerably in Western countries. The scientific knowledge base about prognoses for such absences is very limited, but employers and clinicians often predict them to be very long. The aim of this study was to investigate sickness absence and disability pension in a cohort of employees who initially were on long-term sick leave due to psychiatric disorders, with regard to gender, age, socioeconomic status, and previous sickness absence.
Methods
The cohort included 4,891 employees in Sweden, who, in 1999 were aged 20–61 and had a new sick-leave spell >90 days with a psychiatric disorder. Retrospective and prospective registry data on sickness absence and DP for 1996–2002 were obtained. Logistic regressions were performed to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for having a low, intermediate, or high level of sickness absence (<17, 17–90, and 91–365 days, respectively) or DP in 2002.
Results
The mean number of sick-leave days per person per year 3 years prior to inclusion was low; 17 days, but had increased to 211 days by 2000. In 2002, 26% had been granted DP, significantly higher rate among men, while a higher rate of the women had long-term sickness absence. Of all 4,891 subjects, 35% had <17 sick-leave days in 2002. The OR of having low, intermediate, or long-term sickness absence decreased with age. The reverse was found for obtaining DP, for which also low socioeconomic status was an independent predictor of an increased risk (OR = 3.40, CI 2.28–5.08).
Conclusions
Employees with long-term sick leave due to psychiatric disorders did not have a high level of sickness absence in the 3 years prior to inclusion in the study. Also, 3 years after inclusion, only 35% had very low levels of sickness absence, whereas 26% had been granted DP. Employees who were aged 55–61 showed the lowest risk of sick leave but the highest risk of DP. Low SES was a significant predictor of DP in 2002.
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References
Alexanderson K, Brommels M, Ekenvall L, Karlsryd, E, Löfgren A; Sundberg L; Österberg M (2005) Problem inom hälso- och sjukvården kring handläggning av patienters sjukskrivning. Stockholm: Sektionen för personskadeprevention, Institutionen för klinisk neurovetenskap, Karolinska Institutet (Report in Swedish)
Alexanderson K, Hensing G (2004). More and better research needed on sickness absence. Editorial. Scand J Public Health 32:321–323
Alexanderson K, Norlund A (eds) (2004) Sickness absence— causes, consequences, and physicians’ sickness certification practice. A systematic literature review by the Swedish Council on Technology Assessment in Health Care. Scand J Public Health 32(Supplement 63):1–263
Borg K, Hensing G, Alexanderson K (2004). Risk factors for disability pension over 11 years in a cohort of young persons initially sick-listed with low back, neck, or shoulder diagnoses. Scand J Public Health 32(4):272–278
Feeny A, North F, Head J, Canner R, Marmot M (1998) Socioeconomic and sex differentials in reason for sickness absence from the Whitehall II Study. Occup Environ Med 55:91–98
Floderus F, Göransson S, Alexanderson K, Aronsson G (2005) Self-estimated life situation in patients on long-term sick leave. J Rehabil Med 37:1–10
Gjesdal S, Bratberg E (2002) The role of gender in long-term sickness absence and transition to permanent disability benefits. Eur J Public Health (12):180–186
Gjesdal S, Bratberg E (2003). Diagnosis and duration of sickness absence as predictors for disability pension: Results from a three-year, multiregister based and prospective study. Scand J Public Health 31:246–254
Gjesdal S. From long-term sickness absence to disability pension (2003) Studies on predictors of disability pension in Norway [PhD-thesis]. Bergen: University of Bergen, Norway
Guidance on work-related stress, spice of life or kiss of death? Health and safety at work (1999) Luxembourg: European commission, employment & social affairs
Hensing G (1997) Sickness absence and psychiatric disorder—epidemiological findings and methodological considerations [PhD-thesis]. Linköping: Linköping University
Hensing G (2004) Methodological aspects in sickness-absence research. Scand J Public Health 32(Supplement 63):44–48
Hensing G, Alexanderson K, Allebeck P, Bjurulf P (1996) Sick leave due to psychiatric disorder: higher incidence among women and longer duration for men. Br J Psychiatry 169(6):740–746
Hensing G, Brage S, Nygard JF, Sandanger I, Tellnes G (2000) Sickness absence with psychiatric disorders–An increased risk for marginalisation among men? Soc Psychiatry Psychiatr Epidemiol 35(8):335–340
Hensing G, Wahlström R (2004) Sickness absence and psychiatric disorders. In: Alexanderson K, Norlund A (eds) Sickness absence—causes, consequences, and physicians’ sickness certification practice. A systematic literature review by the Swedish Council on Technology Assessment in Health Care. Scandinavian Journal of Public Health 32(Suppl 63):222–255
Holland-Elliott K (2004) What about the workers? London: The Royal Society of Medicine Press
Håkansson R, Wahl I (2000) Långa sjukskrivningar kan vara läkande i sig (Prolonged sick-listing can have healing effects) (In Swedish). Läkartidningen 97(13):1589
Jenkins R (1985) Minor psychiatric morbidity in employed young men and women and its contribution to sickness absence. Br J Ind Med 42:147–154
Järvisalo J, Anderson B, Boedeker W, Houtman I (2005) Mental disorders as a major challenge in prevention of work disability. Kela, Helsinki
Ljungdahl L, Bjurulf P (1991). The accordance of diagnoses in a computerized sick-leave register with doctor’s certificates and medical records. Scand J Soc Med 19(3):148–153
Marklund S (ed) (2001) Worklife and Health in Sweden 2000. National Institute for Working Life, Stockholm
Marmot M (2004) The status syndrome. How social standing affects our health and longevity. Time Books, Henry Holt and Company, LLC, New York
Muto T, Sumiyoshi Y, Sawada S, Momotani H, Itoh I, Fukuda H, et al. (1999) Sickness absence due to mental disorders in Japanese workforce. Ind Health 37(2):243–252
Nachemson A, Jonsson E (eds) (2000) Neck and Back Pain. The Scientific Evidence of Causes, Diagnoses, and Treatment. Lippincott Williams & Wilkins, Philadelphia
North F, Syme SL, Feeney A, Head J, Shipley MJ, Marmot MG (1993) Explaining socioeconomic differences in sickness absence: the Whitehall II Study. BMJ 306(6874):361–366
Nystuen P, Hagen KB, Herrin J (2001) Mental health problems as a cause of long-term sick leave in the Norwegian workforce. Scand J Public Health 29(3):175–182
OECD (2005) Best practice for reducing sickness and disability absences. Chapter 3. In: Economic Survey of Sweden: Organisation for Economic Co-operation and Development
Ockander M, Timpka T (2001) A female lay perspective on the establishment of long-term sickness absence. Int J Soc Welfare 10(1):74–79
Persson G, Danielsson M, Rosén M, Alexanderson K, Lundberg O, Lundgren B, et al. (2006) Health in Sweden—The National Public Health Report 2005. Scand J Public Health (Supplement 67):1–269
Reijneveld SA (2005) Mental health as a public health issue. Eur J Public Health 15(2):111
SCB (1989) Folk- och bostadsräkningen 1985. Yrke och socioekonomisk indelning (SEI) (in Swedish)
Sandanger I, Nygård JF, Brage S, Tellnes G (2000) Relation between health problems and sickness absence: gender and age differences—A comparison of low-back pain, psychiatric disorders, and injuries. Scand J Public Health 28(4):244–252
Shiels C, Gabbay MB, Ford FM (2004) Patient factors associated with duration of certified sickness absence and transition to long-term incapacity. Br J Gen Pract 54(499):86–91
Stansfeld S, Feeney A, Head J, Canner R, North F, Marmor M (1995) Sickness Absence for Psychiatric Illness: the Whitehall II Study. Soc Sci Med 40(2):189–197
Stansfeld SA, Fuhrer R, Head J, Ferrie J, Shipley M (1997) Work and psychiatric disorder in the Whitehall II Study. J Psychosom Res 43(1):73–81
Stansfeld SA, Marmot MG (1992) Social class and minor psychiatric disorder in British Civil Servants: a validated screening survey using the General Health Questionnaire. Psychol Med 22:739–749
Statistics Sweden (2004) Sysselsättning och arbetslöshet 1975–2003 (Occupation and unemployment 1975–2003). (In Swedish) Stockholm
Tisza SM, Mottl III JR, B MD (2003) Current trends in worker’s compensation stress claims. Curr Opin Psychiatry 16:571–574
Upmark M, Lundberg I, Sadigh J, Allebeck P, Bigert C (1999) Psychosocial characteristics in young men as predictors of early disability pension with a psychiatric diagnosis. Soc Psychiatry Psychiatr Epidemiol 34(10):533–540
Vingård E, Alexanderson K, Norlund A (2004) Consequences of being on sick leave. A systematic review. Scand J Public Health 32(Supplement 63):207–215
WHO (1993) International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD–10). Chapter V (F). WHO, Geneva
Waddell G, Burton K (2006) Is working good for your health and well-being? Cardiff University & University of Huddersfield, Cardiff & Huddersfield
Acknowledgment
This study was funded by grants from AFA Insurance and the Swedish Council for Working Life and Social Research.
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Vaez, M., Rylander, G., Nygren, Å. et al. Sickness absence and disability pension in a cohort of employees initially on long-term sick leave due to psychiatric disorders in Sweden. Soc Psychiat Epidemiol 42, 381–388 (2007). https://doi.org/10.1007/s00127-007-0189-9
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DOI: https://doi.org/10.1007/s00127-007-0189-9