Employees Sick-Listed with Mental Disorders: Who Returns to Work and When?

C A M Roelen,J J L Van Der Klink,P C Koopmans,G Norder,U Bültmann,W Van Rhenen

doi:10.1007/s10926-012-9363-3

Abstract

To investigate return to work (RTW) in employees sick-listed with mental disorders classified according to the International Classification of Diseases (ICD). Sickness absences (SA) medically certified as emotional disturbance (ICD-10 R45) or mental and behavioral disorders (ICD-10 F00-F99) were retrieved from an occupational health service register. RTW was associated with age, gender, and socioeconomic position (SEP) by parametric survival analysis. Emotional, neurotic, somatoform, stress-related, and mood disorders encompassed 94 % of all mental SA. Employees with emotional disturbance had the highest RTW rates: after 1 year 95 % had resumed work and after 2 years 98 % compared to 89 and 96 % of employees with neurotic, somatoform and stress-related disorders, and 70 and 86 % of employees with mood disorders. The probability of RTW decreased after 1 month of SA due to emotional disturbance, 2 months of SA with neurotic, somatoform and stress-related disorders, and 3 months of SA with mood disorders. Women resumed their work later than men. Young employees presenting with emotional disturbance, neurotic, somatoform, and stress-related disorders had earlier RTW than older employees and low-SEP employees had earlier RTW than high-SEP employees. RTW rates and probabilities differed across categories of mental disorders. Age and SEP were associated with RTW of employees with emotional, neurotic, somatoform, and stress-related disorders, but not with RTW of employees experiencing mood disorders. To maximize the likelihood of RTW, a focus on RTW is important in the first months after reporting sick with mental disorders.

Highlights

Mental disorders occur frequently and account for an increasing burden of disease in developed countries [1,2]
A total of 51,754 employees (21,146 men and 30,608 women) had 57,026 Sickness absences (SA) episodes due to mental disorders; 5,272 (10 %) employees had more than 1 mental SA episode and 2,644 (5 %) recurrent episodes were diagnosed within the same International Classification of Diseases (ICD)-10 category as the first SA episode
26 % of employees with mental disorders resumed work within 1 month of reporting sick, 47 % within 3 months, 70 % within 6 months, 87 % within 12 months and 95 % within 24 months; 5 % of employees with mental disorders were assessed for a disability pension

Summary

Introduction

Mental disorders occur frequently and account for an increasing burden of disease in developed countries [1,2]. The prevalence of mental disorders peaks during working age, which makes them a major cause of sickness absence [3,4]. Employed people with mental disorders lose three times more work days in a 12-months’ period compared to people without mental disorders [2]. Mental disorders are associated with an increased risk of disability pensioning [5,6,7,8,9]. The Organization for Economic Co-operation and Development reported that mental disorders account for up to one-third of disability pension awards in western European countries [10].

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Conclusion