Factors Contributing to Long-Term Sickness Absence from Workplace

Long-term sickness absence due to mental disorders (LTSA-MD) is linked to individual features, work conditions, and psychosocial factors, according to research published in PLOS One.

Researchers from the University of Sao Paulo in Brazil interviewed 385 workers on sick leave for more than 15 days in order to compare factors associated with long-term sickness absence between workers who claimed social benefits due to mental disorders or by other causes. The researchers investigated individual features as well as occupational characteristics. The cases were categorized as patients with disabling psychiatric illnesses (including affective disorders [53.7 percent], neurotic/stress-related and somatoform disorders [32.6 percent], and others), while controls were participants with other disabling diseases (injury, poisoning, and other external causes [36.9 percent], musculoskeletal diseases [19.6 percent], digestive system diseases [7.6 percent], circulatory system diseases [5.3 percent], neoplasms [5.3 percent], and others [25.3 percent]).

In the interviews, data was collected regarding sociodemographic information, health habits, lifestyle, health conditions, and work life conditions. The researchers also assessed the participants’ perception of the Demand Control Support (DCS) and Effort Reward Imbalance (ERI) models.

About half of the study population were women (56.6 percent) with a mean age of 34.8 years. Most were non smokers (81.3) and reported physical activity in the previous month (74 percent). Nearly all participants (91 percent) reported seeking medical attention in the prior year for emotional disturbances (48.3 percent) and back pain (35.6 percent). Violence was reported in the workplace by 80.5 percent of the participants, which broke down into the following categories:

• Verbal abuse 61.8 percent
• Harassment 53.8 percent
• Be the target of jokes and discrimination 48.6 percent
• Threats of aggression 35.1 percent
• Assault at work on en route to work 29.3 percent
• Sexual harassment 12.2 percent
• Physical aggression 9.3 percent
• Sexual violence 1.0 percent

“Individual features and psychosocial work conditions were significantly associated with LTSA-MD compared to other causes of sick leave,” the authors discussed. “In addition, dimensions of occupational stress assessed by the DCS and ERI models were significantly associated with LTSA-MD.”

The researchers commented that females tend to deem reporting psychiatric symptoms more than men do, which could have contributed to the fact that sex was a sociodemographic variable associated with LTSA-MD. Sick leave episodes were also linked to females’ frequent assumption of what the researchers termed a “double burden” of juggling work and family life.

The stressors in the work environment associated with LTSA-MD were characterized as low control, high demands, low social support, high effort, low reward, and high over commitment. Exposure to violence in the workplace also stood out as an important factor in prior studies, too.

“Resourceful use of this information may contribute to the implementation of preventive actions and strategies to facilitate return to work targeting the populations most susceptible to mental disorders,” the researchers commented.