Halonen, JI;
Hiilamo, A;
Butterworth, P;
Wooden, M;
Ervasti, J;
Virtanen, M;
Sivertsen, B;
... Lallukka, T; + view all
(2020)
Psychological distress and sickness absence: Within- versus between-individual analysis.
Journal of Affective Disorders
, 264
pp. 333-339.
10.1016/j.jad.2020.01.006.
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Abstract
BACKGROUND Uncertainty remains whether associations for psychological distress and sickness absence (SA) observed between and within individuals differ, and whether age, gender and work-related factors moderate these associations. METHODS We analyzed SA records of 41,184 participants of the Finnish Public Sector study with repeated survey data between 2000 and 2016 (119,024 observations). Psychological distress was measured by the General Health Questionnaire (GHQ-12), while data on SA days were from the employers’ registers. We used a hybrid regression estimation approach adjusting for time-variant confounders—age, marital status, occupational class, body mass index, job contract type, months worked in the follow-up year, job demand, job control, and workplace social capital—and time-invariant gender (for between-individual analysis). RESULTS Higher levels of psychological distress were consistently associated with SA, both within- and between-individuals. The within-individual association (incidence rate ratio (IRR) 1.68, 95% CI 1.61−1.75 for SA at high distress), however, was substantially smaller than the between-individual association (IRR 2.53, 95% CI 2.39−2.69). High levels of psychological distress had slightly stronger within-individual associations with SA among older (>45 years) than younger employees, lower than higher occupational class, and among men than women. None of the assessed work unit related factors (e.g. job demand, job control) were consistent moderators. LIMITATIONS These findings may not be generalizable to other working sectors or cultures with different SA policies or study populations that are male dominated. CONCLUSIONS Focus on within-individual variation over time provides more accurate estimates of the contribution of mental health to subsequent sickness absence.
| Type: | Article |
|---|---|
| Title: | Psychological distress and sickness absence: Within- versus between-individual analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jad.2020.01.006 |
| Publisher version: | https://doi.org/10.1016/j.jad.2020.01.006 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | between-individual; psychological distress; sickness absence; within-individual |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10093569 |
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