Background
Methods
Participants and design
Outcome measures
Exposure variables
Reasons for sickness absence | Mental health reasons
n = 725
n (%) | Other health reasons
n = 1,311
n (%) |
---|---|---|
Anxiety | 218 (30.1) | 0 (0) |
Depression | 405 (55.9) | 0 (0) |
Stress and burnout | 516 (71.2) | 0 (0) |
Other mental illness | 79 (11.0) | 0 (0) |
Personal problems | 139 (19.2) | 34 (2.6) |
Psychosocial working environment | 166 (22.9) | 46 (3.5) |
Cardiovascular or lung diseases | 25 (3.5) | 106 (8.1) |
Infection | 19 (2.6) | 53 (4.0) |
Chronic/diffuse pain | 85 (11.7) | 197 (15.0) |
Cancer | 16 (2.2) | 66 (5.0) |
Abdominal illness | 32 (4.4) | 63 (4.8) |
Musculoskeletal disorders | 74 (10.2) | 799 (61.0) |
Other/unclear reason | 74 (10.2) | 210 (16.0) |
Covariates
Variable | Mental health reasons (n = 725) n/mean %/sd | Other health reasons (n = 1,311)
n/mean %/sd |
P-value* | ||
---|---|---|---|---|---|
Gender (female) | 481 | 66.3 | 679 | 51.8 | <0.001 |
Age (years) | 42.3 | 10.6 | 45.7 | 11.2 | <0.001 |
Highest level of education | |||||
Primary school/Secondary school | 182 | 25.1 | 405 | 30.9 | <0.001 |
Tertiary education <3 years | 307 | 42.3 | 617 | 47.1 | |
Tertiary education >3 years | 236 | 32.6 | 289 | 22.0 | |
Employment | |||||
Supported jobs/early age pension | 24 | 3.3 | 37 | 2.8 | <0.001 |
Student | 43 | 5.9 | 36 | 2.8 | |
Unemployed | 105 | 14.5 | 130 | 9.9 | |
Unskilled worker (e.g. cleaning) | 100 | 13.8 | 263 | 20.1 | |
Skilled worker (e.g. artisan) | 93 | 12.8 | 293 | 22.4 | |
White collar worker (e.g. nurse) | 320 | 44.1 | 427 | 32.6 | |
Self-employed | 40 | 5.5 | 125 | 9.5 | |
Recovery expectations | |||||
0–30 % | 87 | 12.0 | 90 | 6.9 | <0.001 |
40–60 % | 160 | 22.1 | 151 | 11.5 | |
70–90 % | 180 | 24.8 | 211 | 16.1 | |
100 % | 298 | 41.1 | 859 | 65.5 |
Ethical considerations
Statistical analysis
Results
Reason for sickness absence | CIP % (95 % CI) | Crude analysis a
RR (95 % CI) | Adj. model 1 RR (95 % CI) | Adj. model 2 RR (95 % CI) | Adj. model 3 RR (95 % CI) |
---|---|---|---|---|---|
Other health reasons
n = 1,311 | 67 (65;70) | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) |
Mental health reason
n = 725 | 56 (52;59) | 0.87 (0.80;0.93) | 0.89 (0.82;0.96) | 0.92 (0.85;0.99) | 1.01 (0.95;1.08) |
Mental health reasons
n = 721 Mean (sd) | Other health reasons
n = 1,297 Mean (sd) | Diff |
p-value* | |
---|---|---|---|---|
Mean duration in | ||||
Sickness absence | 27.50 (17.57) | 22.53 (17.76) | 4.97 | <0.0001 |
Work | 15.96 (17.20) | 22.45 (19.00) | −6.49 | <0.0001 |
Unemployment | 3.38 (6.69) | 2.80 (7.12) | 0.58 | 0.07 |
Temporary support | 4.18 (9.49) | 2.91 (8.14) | 1.27 | <0.01 |
Permanent support | 0.98 (5.42) | 1.31 (6.23) | −0.33 | 0.24 |
Mean number of episodes in | ||||
Sickness absence | 1.32 (0.78) | 1.37 (0.99) | −0.05 | 0.25 |
Work | 1.02 (1.07) | 1.17 (1.21) | −0.15 | <0.01 |
Unemployment | 0.62 (1.14) | 0.50 (1.12) | 0.11 | 0.03 |
Temporary support | 0.52 (0.97) | 0.38 (0.86) | 0.14 | <0.001 |
Permanent support | 0.05 (0.22) | 0.06 (0.25) | −0.02 | 0.17 |
Mean number of episodes (total) | 3.52 (2.90) | 3.48 (2.93) | 0.04 | 0.76 |
Mean number of different elements in sequence | 2.32 (0.97) | 2.27 (0.84) | 0.05 | 0.20 |
Volatility indicator | 0.37 (0.24) | 0.40 (0.22) | −0.04 | <0.001 |
Integration indicator | 0.36 (0.38) | 0.49 (0.40) | −0.13 | <0.0001 |
Clusters | Mental health reason
n = 721 n (%) | Other health reason
n = 1,297 n (%) | Crude analysisa
OR (95 % CI) | Adj. model 1 OR (95 % CI) | Adj. model 2 OR (95 % CI) | Adj. model 3 OR (95 % CI) |
---|---|---|---|---|---|---|
1. Sickness absence | ||||||
317 (44.0) | 422 (32.5) | 1.35 (1.10;1.65) | 1.30 (1.06;1.59) | 1.31 (1.06;1.60) | 1.05 (0.85;1.31) | |
2. Relapse | ||||||
17 (2.4) | 15 (1.2) | 2.69 (1.31;5.52) | 2.69 (1.29;5.59) | 2.65 (1.27;5.52) | 2.77 (1.31;5.87) | |
3. Sickness absence/temporary support | ||||||
39 (5.4) | 35 (2.7) | 1.92 (1.17;3.16) | 1.60 (0.97;2.65) | 1.55 (0.94;2.56) | 1.32 (0.80;2.18) | |
4. Temporary support | ||||||
37 (5.1) | 47 (3.6) | 1.45 (0.91;2.32) | 1.12 (0.70;1.82) | 1.11 (0.68;1.79) | 1.12 (0.69;1.82) | |
5. Unemployment | ||||||
32 (4.4) | 66 (5.1) | 0.83 (0.52;1.32) | 0.80 (0.50;1.27) | 0.77 (0.48;1.23) | 0.79 (0.49;1.27) | |
6. Permanent support | ||||||
17 (2.4) | 40 (3.1) | 0.91 (0.50;1.66) | 1.74 (0.90;3.39) | 1.61 (0.83;3.12) | 1.43 (0.73;2.80) | |
7. Slow RTW | ||||||
104 (14.4) | 197 (15.2) | 0.87 (0.66;1.14) | 0.93 (0.70;1.24) | 0.92 (0.69;1.23) | 1.03 (0.77;1.38) | |
8. Fast RTW | ||||||
158 (21.9) | 475 (36.6) | 0.63 (0.50;0.78) | 0.66 (0.52;0.82) | 0.67 (0.53;0.84) | 0.84 (0.66;1.07) |