Sickness absence and presence among employees in treatment for common mental disorders

Purpose: Common mental disorders are a major cause of long-term sickness absence and a reason for disability benefits, although many people with these disorders remain employed. Therefore, it is important to prevent them from taking sick leave or relying on disability benefits. Consequently, we wished to identify the factors associated with sickness presence among patients undergoing treatment. Method: Participants were recruited from patients who met for their first session at a Return to Work clinic. A total of 251 patients completed a questionnaire that included questions on background information, mental health and functioning, and psychosocial work factors. Of these, 49% were fully working, 21.9% were partially working, and 29.1% were on full sickness absence. Results: Fully working patients had fewer symptoms, functioned better, and experienced greater well-being than patients wholly on sick leave. They also experienced work as less demanding, were more appreciative, and had more employment security and autonomy. They reported symptoms, functioning, and well-being at the same level as the partially working group. However, their therapists reported that they functioned better and they themselves considered work demands somewhat less stressful. Conclusions: The results indicate that both symptoms and functional capacity, in addition to work environment, are perceived as more favorable among fully working patients, compared with those completely on sick leave. However, because of the cross-sectional design, we need more studies with prospective design to examine whether these relationships are causal, and to examine when sickness presence is beneficial for patients.