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Predicting the duration of sickness absence for patients with common mental disorders in occupational health care

Author: Nieuwenhuijsen, K. · Verbeek, J.H.A.M. · Boer, A.G.E.M. de · Blonk, R.W.B. · Dijk, F.J.H. van
Type:article
Date:2006
Institution: TNO Kwaliteit van Leven
Source:Scandinavian Journal of Work, Environment and Health, 1, 32, 67-74
Identifier: 239105
doi: doi:10.5271/sjweh.978
Keywords: Workplace · Arbeidsparticipatie · Mental health problems · Prediction rule · Prospective cohort · Return to work · Mental health · Absenteeism · Academic achievement · Adult · Age · Area under the curve · Cohort analysis · Consultation · Controlled study · Depression · Major clinical study · Occupational health service · Occupational physician · Prediction · Probability · Prognosis · Proportional hazards model · Receiver operating characteristic · Scoring system · Teacher · Time · Work resumption · Adjustment Disorders · Anxiety Disorders · Depressive Disorder · Female · Humans · Male · Mental Disorders · Middle Aged · Models, Biological · Occupational Health · Sick Leave · Socioeconomic Factors · Workplace

Abstract

Objectives: This study attempted to determine the factors that best predict the duration of absence from work among employees with common mental disorders. Methods: A cohort of 188 employees, of whom 102 were teachers, on sick leave with common mental disorders was followed for 1 year. Only information potentially available to the occupational physician during a first consultation was included in the predictive model. The predictive power of the variables was tested using Cox's regression analysis with a stepwise backward selection procedure. The hazard ratios (HR) from the final model were used to deduce a simple prediction rule. The resulting prognostic scores were then used to predict the probability of not returning to work after 3, 6, and 12 months. Calculating the area under the curve from the ROC (receiver operating characteristic) curve tested the discriminative ability of the prediction rule. Results: The final C ox's regression model produced the following four predictors of a longer time until return to work: age older than 50 years [HR 0.5, 95% confidence interval (95% CI)0.3-0.8], expectation of duration absence longer than 3 months (HR 0.5,95% CI 0.3-0.8), higher educational level (HR 0.5,95% CI 0.3-0.8), and diagnosis depression or anxiety disorder (HR 0.7, 95% CI 0.4-0.9). The resulting prognostic score yielded areas under the curves ranging from 0.68 to 0.73, which represent acceptable discrimination of the rule. Conclusions: A predict ion rule based on four simple variables can be used by occupational physicians to identify unfavorable cases and to predict the duration of sickness absence. This work is licensed under a Creative Commons Attribution 4.0 International License.