Abstract：
OBJECTIVE: Several predictors have been identified for mental sickness absence, but those for recurrences are not well-understood. This study assesses recurrence rates for long-term mental sickness absence (LTMSA) within subgroups of common mental disorders (CMDs) and identifies predictors of recurrent LTMSA.
METHODS: This historical prospective cohort study used routinely collected data from 16,310 employees obtained from a nationally operating Dutch occupational health service (ArboNed). Total follow-up duration was 23,334 person-years. Overall recurrence rates were assessed using Kaplan-Meier estimators. Recurrence rates within subgroups of CMDs were calculated using person-years. Univariable and multivariable Cox proportional hazards models were used to identify predictors.
RESULTS: 15.6% of employees experienced a recurrent LTMSA episode within three years after fully returning to work after a previous LTMSA episode. Highest recurrence rates for LTMSA were observed after a previous LTMSA episode due to mood or anxiety disorders. Mood or anxiety disorders and shorter previous episode duration were predictors of recurrent LTMSA. No associations were found for age, gender, company size, full-time equivalent and job tenure.
CONCLUSIONS: Employees should be monitored adequately after they fully returned to work after LTMSA. It is recommended to monitor high-risk employees (i.e. employees with mood or anxiety disorders and short LTMSA episode) more intensively, also beyond full return to work. Moreover, diagnosis of anxiety and depressive symptoms should be given a higher priority in occupational healthcare.
METHODS: This historical prospective cohort study used routinely collected data from 16,310 employees obtained from a nationally operating Dutch occupational health service (ArboNed). Total follow-up duration was 23,334 person-years. Overall recurrence rates were assessed using Kaplan-Meier estimators. Recurrence rates within subgroups of CMDs were calculated using person-years. Univariable and multivariable Cox proportional hazards models were used to identify predictors.
RESULTS: 15.6% of employees experienced a recurrent LTMSA episode within three years after fully returning to work after a previous LTMSA episode. Highest recurrence rates for LTMSA were observed after a previous LTMSA episode due to mood or anxiety disorders. Mood or anxiety disorders and shorter previous episode duration were predictors of recurrent LTMSA. No associations were found for age, gender, company size, full-time equivalent and job tenure.
CONCLUSIONS: Employees should be monitored adequately after they fully returned to work after LTMSA. It is recommended to monitor high-risk employees (i.e. employees with mood or anxiety disorders and short LTMSA episode) more intensively, also beyond full return to work. Moreover, diagnosis of anxiety and depressive symptoms should be given a higher priority in occupational healthcare.
摘要：
目标：已经确定了几种精神疾病缺勤的预测因素，但是那些复发的人还没有得到很好的理解。这项研究评估了常见精神障碍（CMD）亚组中长期精神疾病缺勤（LTMSA）的复发率，并确定了LTMSA复发的预测因素。
方法：这项具有历史意义的前瞻性队列研究通常收集了来自荷兰一家全国性职业卫生服务机构（ArboNed）的16,310名员工的数据。总随访时间为23334人年。使用Kaplan-Meier估算器评估总体复发率。使用人年计算CMD亚组内的复发率。使用单变量和多变量Cox比例风险模型来识别预测因子。
结果：15.6％的员工在上一次LTMSA发作后完全重返工作岗位后，在三年内反复出现了LTMSA发作。由于情绪或焦虑症，先前的LTMSA发作后观察到LTMSA的复发率最高。情绪或焦虑症以及较短的先前发作持续时间是LTMSA复发的预测因素。没有发现年龄的关联，性别,公司规模,全职同等职位和工作任期。
结论：员工在LTMSA后完全重返工作岗位后，应进行充分的监控。建议更密集地监测高风险员工(即有情绪或焦虑症和LTMSA短暂发作的员工)，也超越了完全重返工作岗位。此外，焦虑和抑郁症状的诊断应在职业保健中得到更高的重视。
方法：这项具有历史意义的前瞻性队列研究通常收集了来自荷兰一家全国性职业卫生服务机构（ArboNed）的16,310名员工的数据。总随访时间为23334人年。使用Kaplan-Meier估算器评估总体复发率。使用人年计算CMD亚组内的复发率。使用单变量和多变量Cox比例风险模型来识别预测因子。
结果：15.6％的员工在上一次LTMSA发作后完全重返工作岗位后，在三年内反复出现了LTMSA发作。由于情绪或焦虑症，先前的LTMSA发作后观察到LTMSA的复发率最高。情绪或焦虑症以及较短的先前发作持续时间是LTMSA复发的预测因素。没有发现年龄的关联，性别,公司规模,全职同等职位和工作任期。
结论：员工在LTMSA后完全重返工作岗位后，应进行充分的监控。建议更密集地监测高风险员工(即有情绪或焦虑症和LTMSA短暂发作的员工)，也超越了完全重返工作岗位。此外，焦虑和抑郁症状的诊断应在职业保健中得到更高的重视。
