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Association Between Illness Perceptions and Return-to-Work Expectations in Workers with Common Mental Health Symptoms

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Abstract

Purpose Mental health symptoms (MHSs) may affect people’s work capacity and lead to sickness absence and disability. Expectations and perceptions of illness have been shown to influence return to work (RTW) across health conditions, but we know little about illness perceptions and RTW-expectations in MHSs. The aim of this study was to investigate the association between illness perceptions and RTW-expectations in a group struggling with work participation due to MHSs. Methods Cross-sectional associations between illness perceptions and return to work expectations at baseline were analyzed for 1,193 participants who reported that MHSs affected their work participation. The study was part of a randomized controlled trial evaluating the effect of job focused Cognitive Behavioral Therapy (CBT) combined with supported employment (IPS). Participants were from a working age population with diverse job status. Results There was a strong and salient relationship between illness perceptions and RTW-expectations. When adjusting for demographic and clinical variables, the components consequences, personal control, identity and illness concern remained significantly associated with uncertain and negative RTW-expectations. Less illness understanding remained significantly associated with uncertain RTW-expectations, while timeline and emotional representations remained significantly associated with negative RTW-expectations. In the fully adjusted model only the consequences component (believing that illness has more severe consequences) remained significantly associated with RTW-expectations. Openly asked, participants reported work, personal relationships and stress as main causes of their illness. Conclusions In people with MHSs who struggle with work participation, perceptions and beliefs about their problems are strongly associated with their expectations to return to work.

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Acknowledgments

This research was funded by the Norwegian Labor and Welfare Administration. Ingrid Blø Olsen helped to develop a framework for categorization of the causal item on the Brief Illness Perception Questionnaire and with the categorization of responses to this item.

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Authors and Affiliations

  1. Uni Health, Uni Research, Krinkelkroken 1, 5015, Bergen, Norway

    Camilla Løvvik, Mari Hysing & Silje E. Reme

  2. Department of Health Promotion and Development, University of Bergen, Bergen, Norway

    Camilla Løvvik & Simon Øverland

  3. Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway

    Simon Øverland

  4. Department of Psychological Medicine, University of Auckland, Auckland, New Zealand

    Elizabeth Broadbent

  5. Harvard School of Public Health, Boston, MA, USA

    Silje E. Reme

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  1. Camilla Løvvik
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Correspondence to Camilla Løvvik.

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Løvvik, C., Øverland, S., Hysing, M. et al. Association Between Illness Perceptions and Return-to-Work Expectations in Workers with Common Mental Health Symptoms. J Occup Rehabil 24, 160–170 (2014). https://doi.org/10.1007/s10926-013-9439-8

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  • DOI: https://doi.org/10.1007/s10926-013-9439-8

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