Beyond return to work from sickness absence due to mental disorders:5-year longitudinal study of employment status among production workers

Background: Mental disorders are increasing and account for one-third of all disability benefits in OECD countries. This study investigated the work status after mental sickness absence (SA). Methods: Five-year longitudinal cohort study of 6678 male production workers. Work status, work schedule and work hours/week were retrieved from employer records in five years following RTW from mental SA. Longitudinal analysis was done with linear and logistic generalized estimating equations estimating relative risks (RRs) and odds ratios (ORs), respectively, controlled for age, marital status and occupational grade. Results: In total, 4613 (69%) workers had complete data and were included in the analyses; 552 of them had experienced mental SA. In the years following mental SA, 102 (18%) workers left employment compared to 384 (9%) workers without mental SA. In the first year after mental SA, workers left employment at their own request and in later years they were dismissed because of poor work functioning. After mental SA, workers more often (RR = 2.93; 95% CI 1.83-4.03) reduced their work hours/week than those without mental SA, whereas the odds of changing work schedule did not differ between them (OR = 1.02; 95% CI 0.84-1.24). Conclusions: After mental SA, workers left employment or reduced work hours/week more often than those without mental SA. The results suggest that changes in employment status are more common after SA caused by mental disorders as compared with somatic disorders.