Abstract
BackgroundDepression is a common and highly recurrent mental disorder that is accompanied by poor functioning at home and at work. Not all depressed employees report sick and little is known about variables associated with sickness absence (SA) due to depression. Recurrent SA due to depression tends to marginalize employees from the workforce and exclude them from social participation. Therefore, this study sought group consensus on factors predicting recurrent SA due to depression.Methodology/principal findings23 scientists in the field of work and mental health and 23 physicians with expertise in assessing work disability were invited for a Delphi study. Sixty-seven factors retrieved from the literature were scored for their impact on the recurrence of SA due to depression, range 1 (no impact) to 10 (very high impact) in two Delphi rounds. The third Delphi round addressed the assessability and modifiability of elected predictors. Group consensus was defined as 75% agreement. In the first round (response 78%), group consensus was reached on a high impact of 13 factors on recurrent SA due to depression. The second round (response 79%) added another 8 factors with high impact on recurrent SA due to depression. The panelists were of the opinion that stressful life and work events, age at first diagnosis, duration of the last depressive episode, anxiety, lifetime number of depressive episodes, and psychological work demands were readily assessable in consultation with patients. Furthermore, work factors, particularly decision latitude, psychological job demands, and commitment to work, were recognized as modifiable.Conclusions/significanceAlthough results have to be validated with further quantitative research, physicians may identify employees at risk of recurrent SA due to depression and may support them to adjust their work aimed at increasing commitment to work and preventing future SA due to depression.
Highlights
Depression is a common disorder in developed countries with a lifetime prevalence of up to 25% for women and 12% for men [1]
Group consensus was reached on a high impact of the lifetime number of depressive episodes, substance abuse, residual symptoms after resuming work, social and work dysfunctioning, comorbid anxiety and comorbid DSM disorders, neuroticism, stressful events in private life or at work, commitment to work, and high demands in work combined with low control over work (Table 2)
Second Delphi round In the second Delphi round, 34 (79%) of 43 remaining panel members returned the questionnaire and group consensus was reached on another 8 predictors: age at the time of the first depressive episode, severity and duration of the first and last
Summary
Depression is a common disorder in developed countries with a lifetime prevalence of up to 25% for women and 12% for men [1]. Studies of work productivity and functioning of depressed employees most frequently consider disease-related factors, whereas personal factors and work-related factors are less frequently addressed. Work productivity was found to be strongly associated with the duration of depression and moderately with the severity of depression, co-morbid mental or physical disorders, older age, and a history of previous SA or work disability [5]. Since 2000, literature reviews have reported a total of 67 factors predicting recurrences of depression [7,8,9,10,11,12,13,14,15,16]. Depression is a common and highly recurrent mental disorder that is accompanied by poor functioning at home and at work. This study sought group consensus on factors predicting recurrent SA due to depression
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