Predictors of time until return to work and duration of sickness absence in sick-listed precarious workers with common mental disorders: a secondary data-analysis of two trials and one cohort study

Yvonne B Suijkerbuijk; Frederieke G Schaafsma; Lyanne P Jansen; Selwin S Audhoe; Lieke Lammerts; Johannes R Anema; Karen Nieuwenhuijsen

doi:10.1186/s13033-023-00613-7

Predictors of time until return to work and duration of sickness absence in sick-listed precarious workers with common mental disorders: a secondary data-analysis of two trials and one cohort study

Int J Ment Health Syst. 2023 Dec 8;17(1):48. doi: 10.1186/s13033-023-00613-7.

Authors

Yvonne B Suijkerbuijk^{1

2}, Frederieke G Schaafsma^{3

4

5}, Lyanne P Jansen^{3

4}, Selwin S Audhoe⁴, Lieke Lammerts⁵, Johannes R Anema^{4

5}, Karen Nieuwenhuijsen^{3

4}

Affiliations

¹ Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. y.b.suijkerbuijk@amsterdamumc.nl.
² Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands. y.b.suijkerbuijk@amsterdamumc.nl.
³ Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
⁴ Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
⁵ Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, location Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands.

Abstract

Background: Common mental disorders (CMD) are highly prevalent among sick-listed precarious workers and often lead to long-term sickness-absence, work disability and unemployment. This study aimed to identify predictors of a longer time until return to work (RTW) and prolonged duration of sickness absence in sick-listed precarious workers with CMD.

Methods: We conducted a secondary Cox regression analysis using existing data from two Dutch randomized controlled trials and one cohort study among sick-listed precarious workers with CMD (N = 681). Age, gender, baseline employment status, study allocation, severity of psychological symptoms and RTW self-efficacy were evaluated for their predictive value on time until sustainable (≥ 28 days) RTW and duration of sickness absence during 12-month follow-up. In this study, time until sustainable RTW and duration of sickness absence are distinct dependent variables, because they are not mutually exclusive.

Results: Age above 50 years (HR 0.57, 95% CI 0.39-0.82), severe psychological symptoms (HR 0.64, 95% CI 0.43-0.93), unemployment (HR 0.19 95% CI 0.11-0.33) and loss of employment contract during sickness absence (HR 0.25, 95% CI 0.14-0.47) were predictive of a longer time until RTW. Male gender (HR 0.77, 95% CI 0.62-0.97), severe psychological symptoms (HR 0.64, 95% CI 0.46-0.87), unemployment (HR 0.47, 95% CI 0.27-0.84) and loss of employment contract (HR 0.48, 95% CI 0.26-0.90) predicted a prolonged duration of sickness absence.

Conclusions: Unemployment at the moment of sick-listing, loss of employment contract during sickness absence, and severe psychological symptoms are predictors of both a longer time until RTW and prolonged duration of sickness absence among sick-listed precarious workers with CMD. This knowledge assists occupational health and mental health professionals in the early identification of workers at risk of long-term sickness absence, enabling them to arrange targeted occupational rehabilitation support and mental health care.

Trial registration: The included randomized controlled trials were prospectively registered in the Dutch national trial register under NTR4190 (September 27, 2013) and NTR3563 (August 7, 2012).

Keywords: Mental Health; Return to work; Sick leave; Social Security; Vocational Rehabilitation.