Sickness Absence Research Articles

Assessing the return-to-work mode of Dutch precarious workers with mental health issues

Abstract Background Mental health issues are highly prevalent among precarious workers, often leading to sickness absence, work disability, and job loss. Return to work (RTW) is more challenging for these workers, as they often lack a job to return to and have limited access to occupational health care. Perceptions and attitudes about RTW are important determinants and can be categorized into three modes within the RTW process: a passive, an ambivalent and an active RTW-mode. To identify the RTW mode, we developed the RE-MODE tool. This study aimed to assess occupational health professionals’ agreement on the RTW-mode of sick-listed precarious workers with mental health issues using RE-MODE. Methods In a vignette study, 71 occupational health professionals from a Dutch social security institute viewed six videos of consultations between insurance physicians and precarious workers. They then used RE-MODE to assess the RTW mode and need for RTW-support. They also provided feedback on the tool’s validity and usability. We used a generalized linear mixed model to analyze inter-rater agreement, inter-item consistency, and the contribution level of each item. Additionally, we calculated the content validity index and the system usability scale. Results The agreement on the RTW mode with RE-MODE is high (ICC 0.86, 95% CI 0.64-0.95) and on the workers’ need for RTW-support moderate (0.61, 95% CI 0.31-0.84). Furthermore, the content-validity (Scale-CVI 0.83), usability (SUS 0.75), and inter-item consistency (Cronbach’s Alpha 0.70) show favorable results. We are currently analyzing the contribution of each item to the total score. The items with the best overall performance will be included in RE-MODE 2.0. Conclusions REMODE is a valuable tool for occupational health professionals to identify precarious workers with mental health issues at risk of long-term disability. Then they can arrange targeted RTW-support. Based on the study results, RE-MODE 2.0 is in development. Key messages • RE-MODE is a valuable tool for the assessment of the RTW-mode of precarious workers with mental health issues. • RE-MODE’s reliability, content-validity and usability is satisfactory.

Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM)

BackgroundMusculoskeletal disorders are commonly treated in primary healthcare and may, if not treated adequately, entail a risk for long-term disability and sickness absence. A team-based rehabilitation intervention (PREVention of Sickness Absence for Musculoskeletal disorders, PREVSAM) was evaluated in a randomised controlled trial. The purpose of this study was to evaluate the process of implementing the PREVSAM model in primary care rehabilitation.MethodsThis process evaluation was conducted alongside the trial, collecting quantitative and qualitative data to evaluate how the PREVSAM model was implemented, mechanisms of impact, and contextual factors. Acceptability, feasibility, appropriateness, adaptations, training and support, resources, recruitment, reach, retention, dose, fidelity, and readiness for change were investigated. Qualitative data were collected from healthcare professionals and patients.ResultsEight of 22 invited rehabilitation clinics (36%) and 28 of 54 healthcare professionals (52%) were included in the PREVSAM trial and this process evaluation. Of 507 eligible patients, 261 (51%) were included. Of those, 134 were randomised to the intervention and 129 (96%) were retained. Twelve healthcare professionals and 15 patients participated in the qualitative evaluations. The model’s essential components; individual assessments and structured, team-based rehabilitation with clear division of responsibilities agreed in a joint health plan; were generally delivered according to protocol. The optional components early access to psychological treatment and workplace contact were delivered to a lesser extent. Perceived acceptability, feasibility, and appropriateness of the PREVSAM model were moderate to high. Several contextual barriers, in the form of missing prerequisites, affected the implementation. Qualitative data showed that the model, with its holistic view, was appreciated by both healthcare professionals and patients.ConclusionsThis process evaluation suggests that PREVSAM is acceptable, feasible and appropriate for patients with MSDs reporting psychological risk factors associated with increased risk for sickness absence. While essential components were implemented with fidelity for most patients, optional components were not. This variability reflects the complexity of the model, its mandatory and optional components, contextual barriers, and the person-centred approach meeting individual patient needs. As all model components were not delivered to all patients, the intervention may have been too similar to treatment as usual to detect differences on a group level. A limitation of the study is that half of the participating rehabilitation clinics withdrew prematurely.

Do job demands and resources differ between permanent and temporary eldercare workers in Sweden?

Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared with permanent workers, but this has been largely understudied. To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers. Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors. A total of 1076 permanent and 675 temporary workers received the survey, and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers. Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.

Sex-specific socioeconomic risk factors for spontaneous subarachnoid hemorrhage-a case-control study during the 5 years before ictus.

There is a difference in the incidence of spontaneous subarachnoid hemorrhage (SAH) between sexes, with the majority of cases occurring in female patients. Although this phenomenon has been studied from a medical perspective, the reasons for the predominance of female cases are still unclear. Non-medical factors, such as a patient's socioeconomic situation, can differ between female and male patients, with health implications. The aim of the study was to identify socioeconomic profiles for both sexes that may be vulnerable to developing SAH. This information could potentially be used for active preventive health efforts. This study was based on a 7-year consecutive cohort of 890 patients with SAH treated at Uppsala University Hospital, along with a sex- and age-matched 5:1 control group from Statistics Sweden. The collected information included demographic data, income that was analyzed through "earnings" (EAs), which is defined as the sum of income and other economic compensations related to work, and "disposable income" (DI), which is the net amount that an individual can use. Pension and sickness-related absence from work were measured using early pension (EP), old age pension (OAP), sickness absence (SA), and disability pension (DP). Univariate and multivariate analyses were used. Among the women, the socioeconomic risk profile for SAH included lower education, unemployment, being registered as living single, residing in a sparsely populated municipality, and increased age. For the men, the risk profile included residing in a sparsely populated municipality and changes in civil status. Both women and men with SAH had lower EAs and DI compared to the controls. Notably, a significantly higher proportion of the women with SAH received DP compared to the controls. Residing in a sparsely populated area was associated with an increased risk for SAH for both women and men. The women with SAH were more economically vulnerable, whereas the men faced a different type of vulnerability related to changes in civil status. We suggest that healthcare organizations use this information to identify individuals at risk and actively implement preventive measures according to stroke guidelines for both groups.

Economic costs of poor PSC manifest in sickness absence and voluntary turnover

Abstract Work-related stress is a major occupational health and safety (OHS) issue that has industrial relations origins. Aside from the moral and human rights imperatives to improve the corporate climate for worker psychological health (as per psychosocial safety climate, PSC), there are strong economic costs for not doing so. PSC refers to worker perceptions of the corporate safety system to protect and promote workers’ psychological health and wellbeing. It is a leading indicator of working conditions, which in turn affect workers’ health and work engagement. In this study, we estimate the attributable economic cost of low PSC due to sickness absence and turnover. Data were collected from a multinational company using survey at Time 1 (T1) and objective company data (i.e., sickness absence and turnover) after one year (T2). Using regression analysis and a matched sample of 617 responses, PSC was negatively related to future sickness absence. A binomial logistic regression with 1268 respondents (i.e., all responses at T1) showed that PSC was negatively related to future voluntary turnover. An economic analysis suggests that improving OHS via PSC could save an organisation with 5000 employees USD 0.6–2.7 million per year. Building PSC to protect and promote workers’ psychological health is a likely economic saving on organisational productivity.

Ill persons and capable workers: Constructing work ability in return-to-work negotiations after sickness absence.

In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.

Translation and cultural adaptation of evidence-informed leaflets on the work-health interface: a pragmatic approach to cultural adaptation.

Our aim was to translate and culturally adapt three evidence-informed leaflets on the work-health interface from English into Norwegian. Integral to this aim was the exploration of the quality and acceptability of each of the adapted leaflets to Norwegian-speaking stakeholders; general practitioners, people who deal with health issues in the workplace, and the general population. Common health problems, such as musculoskeletal pain, account for most workdays lost and disability benefits in Norway. To facilitate return to work, it may be important to have access to evidence-informed information on the work-health interface for stakeholders involved in sickness absence processes. However, there is limited information material available in Norwegian that is tailored for the different stakeholders. Cultural adaptation is an emerging strategy for implementing health information across different populations and regions. Guidelines on cultural adaptation are not well-suited for translating and adapting evidence-informed health information material. We conducted a pragmatic cultural adaptation process informed by existing guidelines. Our conceptual framework for adaptation is situated between adaptation and translation and comprises appraisal, forward- and back-translation, review in multiple steps, sense checking, and re-designing using a transcreation approach. Using an online survey, we aimed to evaluate the overall quality, value, acceptability, and clarity of each of the adapted leaflets to a total of 30 end-users. We translated and culturally adapted three leaflets from English to Norwegian. Adapted leaflets were found to be clearly presented, acceptable, and valued by 45 Norwegian end-users. No differences in key concepts between original and back-translated leaflets emerged through the review process by the original author and forward translators. We used a pragmatic approach in this study that might be useful to others culturally adapting evidence-informed health information material.

Work-family conflicts and sickness absence due to mental disorders among female municipal employees - a register-linked study comparing health and social care employees to employees in other sectors.

This study aimed to examine (i) if work-to-family conflicts (WtFC) and family-to-work conflicts (FtWC) are associated with sickness absence due to mental disorders and (ii) whether these associations are different among health and social care (HSC) employees compared to other municipal employee sectors. The Helsinki Health Study survey data collected in 2017 among 19-39-year-old female municipal employees (N=2557) were prospectively linked to administrative Social Insurance Institution of Finland register data on long-term sickness absence due to mental disorders (SA-MD) covering a follow-up of up to five years. The associations of WtFC and FtWC and SA-MD were analyzed using Cox regression models stratified by employment sector (HSC, education, other), adjusting for sociodemographic and health-related covariates. Of HSC employees, 16% had SA-MD during the follow-up, which surpassed the figures for employees in education (12%) and other (11%) sectors. In the HSC sector, the youngest employees had the highest prevalence of SA-MD and, among HSC employees, prior SA-MD was the most common. In Kaplan-Meier curves, the steepest increase in SA-MD was observed for HSC employees. WtFC [hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.39-2.45] and FtWC (HR 1.78, 95% CI 1.32-2.40) were associated with SA-MD among HSC employees. The associations were rather similar for employees in education and other sectors. Adjusting for work-related factors and health history somewhat attenuated the associations. Better possibilities to combine work and family life might aid in preventing SA-MD in all employment sectors.

Comparative Effectiveness of Antipsychotics in Patients With Schizophrenia Spectrum Disorder

Antipsychotics are the cornerstone of maintenance treatment in schizophrenia spectrum disorders, but it is unclear which agents should be prioritized by prescribers. To investigate the clinical effectiveness of antipsychotics, including recent market entries, in comparison with oral olanzapine in relapse and treatment failure prevention among individuals with schizophrenia spectrum disorder. This comparative effectiveness research study with a within-individual analysis included data from Swedish health care registers of inpatient and specialized outpatient care, sickness absence, and disability pensions among all individuals aged 16 to 65 years who were diagnosed with schizophrenia spectrum disorder from January 1, 2006, to December 31, 2021, including an incident cohort and a prevalent cohort. Specific antipsychotics. The risks for psychosis relapse hospitalization and treatment failure (psychiatric hospitalization, death, or change in an antipsychotic medication) were adjusted for the temporal order of treatments, time since cohort entry, and concomitant drugs. Comparisons of all antipsychotics with oral olanzapine, the most commonly used antipsychotic, were investigated. Among the full cohort of 131 476 individuals, the mean (SD) age of the study cohort was 45.7 (16.2) years (70 054 men [53.3%]). During a median follow-up of 12.0 years [IQR, 5.2-16.0 years], 48.5% of patients (N = 63 730) experienced relapse and 71.1% (N = 93 464) underwent treatment failure at least once. Compared with oral olanzapine, paliperidone 3-month long-acting injectable (LAI) was associated with the lowest adjusted hazard ratio (AHR) in the prevention of relapses (AHR, 0.66; 95% CI, 0.51-0.86), followed by aripiprazole LAI (AHR, 0.77 [95% CI, 0.70-0.84]), olanzapine LAI (AHR, 0.79 [95% CI, 0.73-0.86]), and clozapine (AHR, 0.82 [95% CI, 0.79-0.86]). Quetiapine was associated with the highest risk of relapse (AHR, 1.44 [95% CI, 1.38-1.51]). For prevention of treatment failure, paliperidone 3-month LAI was associated with the lowest AHR (AHR, 0.36 [95% CI, 0.31-0.42]), followed by aripiprazole LAI (AHR, 0.60 [95% CI, 0.57-0.63]), olanzapine LAI (AHR, 0.67 [95% CI, 0.63-0.72]), and paliperidone 1-month LAI (AHR, 0.71 [95% CI, 0.68-0.74]). This comparative effectiveness research study demonstrated large differences in the risk of relapse and treatment failure among specific antipsychotic treatments. The findings contradict the widely held conception that all antipsychotics are equally effective in relapse prevention.

Health impact of the COVID-19 in Spanish non-healthcare workers by gender: Use of sickness absence for surveillance.

At the beginning of the pandemic, the identification of transmission chains was biased towards more closely monitored sectors, such as healthcare and sociosanitary centers. The objective of our research is to describe the impact of the pandemic on the Spanish non-healthcare workers measured through health-related workplace absences. A descriptive study of the cases of COVID-19-related temporary disability (TD) between February 15th and September 17th, 2020, was carried out. TD quarantine/infection ratios were calculated for every economic sector of activity. Rates of COVID-19 TDs per 100,000 affiliated workers were obtained, by gender, age, economic activity of the company or occupation of the worker. A total of 1,126,755 TDs were recorded, 45.4% in women. The overall TD rates were 5,465 quarantines and 1,878 illnesses per 100,000 women, and 4,883 quarantines and 1,690 illnesses per 100,000 men. The highest incidence rates of TD due to illness were observed in younger age groups, under 30. The median TD quarantine/infection ratio was 2.6 (Interquartile range [IQR] 1.5-3.9), and Postal and Courier activities had the highest value: 4.7 quarantines per case (IQR: 3.75-6.12). The TD rates were higher in female workers in most sectors of activity and occupations compared to men in the same sectors and with the same occupations. The results show the uneven impact of COVID-19 by occupation, with a higher rates in less qualified occupations (unskilled workers and laborers) versus the first categories of the table (directors, managers, technicians, and professionals). The results confirmed the high impact of COVID-19 on Spanish non-healthcare workers and it's inequalities. They also confirmed the potential use of TDs as an alternative source for epidemiological, public health surveillance and early warning of new emerging infections.

Job competition in civil service public exams and sick leave behaviour

AbstractIn several countries, a traditional public exam system is the way to secure a job in the civil service. In this setting, candidates have to take and pass exams that involve studying large quantities of material, and this takes up a large amount of time. Candidates who are working while preparing for public exams may find it difficult to find time for both tasks. Thus, they might experience increased stress/anxiety related to the high stakes nature of the civil service recruitment process. In this paper, we investigate the impact of new openings for civil service positions on sickness absences. Using a unique administrative data set on the universe of sickness absences and civil service positions offered in Spain from 2009 to 2015, we find a significant increase in health‐related absences several months before the exam date. In particular, this effect is stronger for individuals working in the educational sector as well as for calls offering a large number of positions. An important element is that our results are mostly driven by stress‐related absences. To corroborate the health‐related origins of our results, we use data on visits to general practitioners and specialists and show a significant deterioration in the health of public‐sector workers. Our results are important from a policy perspective as they highlight the existence of important negative consequences of the civil service recruitment process that have been previously overlooked.

Associations of depressive symptoms and psychosocial working conditions with sickness absences in a Finnish cohort of 11,495 employees

ObjectiveTo examine the relevance of questions on psychosocial working conditions and depressive symptoms, as used in a screening questionnaire in preventive occupational health care, to predict repetitive short or long sickness absences. MethodsThe participants were 11,495 employees of various occupations in Finnish companies. The data were prospectively collected by one occupational healthcare service provider (Finla) and included register data of sickness absences and responses to a questionnaire used in pre-employment and periodic health examinations between 2011 and 2019. Long sickness absences of > 30 days and repetitive short sickness absences of one to ten days in a 24-month follow-up were used as outcome variables for multiple logistic regression analysis. ResultsStrong associations were found between repetitive short and long sickness absences, and the questions on depressive symptoms “felt hopeless about the future”, “felt melancholic”, “felt everything was an effort”, and “feelings of worthlessness”. Among questions on psychosocial working conditions, strong associations were found between sickness absences and questions on decision authority, self-reformation opportunities, job versatility, and appreciation for their work. ConclusionsQuestionnaires on depressive symptoms and psychosocial work environment can help identify patients with an increased risk of sickness absence. Data accumulating in occupational health care should be used more systematically to reduce the risk of work disability through targeted occupational health interventions.

Repeated short‐term sickness absence: A problem to be handled or a symptom to be prevented? A qualitative case study

Repeated short‐term sickness absence: A problem to be handled or a symptom to be prevented? A qualitative case study

A network approach to PhD students’ well-being: insights into risk and protective factors

ABSTRACT Due to the high demands of doctoral education, concerns have been raised about PhD students’ well-being. In addition to the adverse individual impact, poor well-being of PhD students is also problematic for universities, which might lose talented researchers via absenteeism and drop-out. Despite substantial knowledge about factors influencing well-being in academia, we know little about how these factors jointly promote or impede PhD students’ well-being. We applied network analysis, alongside regression analysis, to cross-sectional data from 665 PhD students in the Netherlands to explore how PhD students’ job demands, job resources, and personal resources are associated with subjective and archival well-being indices. Findings suggest that job demands, job resources, and personal resources influence PhD students’ well-being directly and indirectly via associations with other factors. Among job demands, both publication pressure and work-home conflict were associated with higher burnout. Additionally, work-home conflict was associated with higher sickness absenteeism. Psychological capital stood out as the most important resource within the network and was related to lower burnout, higher engagement, and lower sickness absenteeism. By highlighting the importance of personal resources, particularly psychological capital, for PhD students’ well-being, this study can guide the development of interventions to promote PhD students’ well-being.

Psychological therapies for the workforce 2021-2024

As a result of the timely investment, during the Covid-19 pandemic, by Scottish Government in Psychological Therapies for the Workforce, staff in Scotland have had access to interventions and therapy to support their mental health and wellbeing. Funding the service was a clear statement about the value placed on workforce mental health and wellbeing. The service has consistently shown good outcomes and positive feedback. There are strong positive indications, from qualitative feedback and Board data on work status, that the service is contributing in terms of retaining staff and preventing prolonged sickness absence. As we move further from the pandemic demand for the service grows, and plenty more remains to be done to support the workforce. This is a service worthy of further investment.

Gender differences in mental health-related sickness absence in the education sector

BackgroundThe education sector experiences high rates of sickness absence, primarily due to mental health disorders. This issue poses significant challenges, not only for the affected employees but also for their colleagues, pupils, the organization, and the society as a whole. Several factors are likely to contribute to this issue, including work-related factors and gender dynamics, as the education sector has a high proportion of female employees.MethodsIn this study, we use statistical methods to compare the average duration of sickness absence due to mental disorders in the education sector with other sectors. Additionally, we explore the influence of gender, age, and working hours on the duration of sickness absence. For our study we use a large dataset consisting of approximately 200,000 cases of sickness absence due to mental disorders, with more than 32,000 cases from the education sector.ResultsOur analysis shows that average sickness absence duration is consistently longer in the education sector than in other sectors, even after accounting for gender and age. Specifically, the average duration of sickness due to mental disorders in the education sector is 235 days, compared to 188 days in other sectors. We also observe gender differences in absence duration in all sectors, with an interaction effect indicating that working in education affects recovery rates more for men than for women. Consequently, the gender difference in absence duration is smaller in the education sector than in other sectors.ConclusionUsing a large dataset, we find significant differences in absence duration between employees in the education sector and those in other sectors. Other factors, such as gender, also influence sickness absence duration, but to a lesser extent. Notably, the gender effect on absence duration is smaller in the education sector compared to other sectors.

Association between Standard of Living and Sickness Absenteeism among Hypertensive Patients in South Chennai: A Cross-Sectional Study

Association between Standard of Living and Sickness Absenteeism among Hypertensive Patients in South Chennai: A Cross-Sectional Study

Dizziness and vertigo sick leave before and after insurance restrictions – a descriptive Swedish nationwide register linkage study

BackgroundVertigo and dizziness can be disabling symptoms that result in sick leave. Research regarding sickness absence due to dizziness has focused on specific vestibular diagnoses rather than the nonspecific vertigo/dizziness diagnoses. Strict sick leave regulations were introduced in Sweden in 2008. The aim of this study was to describe the vertigo/dizziness sick leave prevalence and duration considering both specific and nonspecific diagnoses according to International Classification of diseases 10th revision (ICD-10) on the 3-digit level, including the less specific “R” diagnoses.MethodsThrough Swedish nationwide registers we identified individuals aged 16–64 years who during the years 2005–2018 were sickness absent > 14 consecutive days – minimum register threshold – due to vertigo/dizziness diagnoses according to ICD10 codes: specific diagnoses (H81.0, H81.1, H81.2, H81.3, H81.4, G11x) and nonspecific (R42, R26, R27, H81.9). We described the demographic characteristics, prevalence and duration of such sick-leave spells. Data were stratified according to diagnostic groups: ataxias, vestibular and nonspecific.ResultsWe identified 52,179 dizziness/vertigo sick leave episodes > 14 days in 45,353 unique individuals between 2005–2018, which constitutes 0.83% from all sick leave episodes in the given period.The nonspecific diagnoses represented 72% (n = 37741) of sick leave episodes and specific vestibular H-diagnoses 27% (n = 14083). The most common specific vestibular codes was Benign paroxysmal positional vertigo (BPPV) 9.4% (n = 4929). The median duration of sick leave was 31 days (IQR 21–61). Women on sick leave were younger than men (47 vs 51 years, p < 0.05) and had a higher proportion of nonspecific diagnoses compared with men (74% vs 70%, p < 0.05).ConclusionsThe vast majority of vertigo/dizziness sick leave episodes were coded as nonspecific diagnoses and occurred in women. BPPV, a curable vestibular condition, was the most common specific diagnosis. This suggests a potential for improved diagnostics. Women on sick leave due to dizziness/vertigo were younger and more often received nonspecific diagnostic codes. Future studies should determine the frequency of use of evidence based therapies and investigate further the gender differences.

Working Status in Patients With Untreated Unruptured Intracranial Aneurysms: A Descriptive Longitudinal Study

BACKGROUND AND OBJECTIVES: Many patients with unruptured intracranial aneurysms (UIAs) remain untreated if the risk of treatment exceeds the estimated risk of aneurysm rupture, potentially leading to diagnosis-related stress and anxiety. Working status may serve as a marker for the total level of function including mental health and psychological burden of the condition. The aim of the study was to assess the working status before and after a diagnosis of an untreated UIA. METHODS: This was a retrospective nationwide registry-based descriptive longitudinal study. It included all working-age patients diagnosed with an UIA in Norway between 2008 and 2018 and 1:1 age-matched and sex-matched controls without a diagnosis of an intracranial aneurysm that were randomly selected from the Norwegian population. The history of sickness absence in the period of 1 year before and after diagnosis was retrieved from The Norwegian Labour and Welfare Administration records and compared between the groups. RESULTS: In total, 2141 patients and 2141 controls were included in the study. Proportion of working patients decreased from 62.1% (95% CI 60.0%-64.1%) 1 year before the diagnosis to 51.3% (95% CI 49.1%-53.4%) 1 year after the diagnosis (P &lt; .001). In comparison, the proportion of working controls decreased from 77.9% (95% CI 76.1%-79.6%) 1 year before day 0 to 73.4% (95% CI 71.5%-75.2%) 1 year after day 0 (P = .001). The odds of working were 86.7% lower among the patients than among the controls (odds ratio 0.133, 95% CI 0.091-0.194; P &lt; .001) when controlled for the baseline working status. The older the individuals, the less likely they were to work (odds ratio 0.908, 95% CI 0.889-0.926; P &lt; .001). CONCLUSION: The work participation of patients diagnosed with UIA is low prediagnosis compared with the general population and decreases significantly postdiagnosis.

Trajectories of work disability among individuals with anxiety-, mood/affective-, or stress-related disorders in a primary healthcare setting

Abstract Background Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors. Methods The study population included working-age individuals, aged 22–62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership. Results Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups. Conclusions Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work.