Psychiatric Sick Leave May Increase Early Mortality

Medical sick leave is designed to offer employese the opportunity to seek treatment, recover, and eventually return to a physical condition that enables them to go back to work. Psychiatric sick leave is designed to achieve the same outcome, but pertains to psychological conditions. However, research has suggested that individuals who take sick leave for psychiatric conditions are at increased risk of mortality either directly or indirectly resulting from their psychological issue.

To determine how psychiatric sick leave might predict early mortality, Anna Bryngelson of the Department of Clinical Sciences at Karolinska Institutet in Sweden recently conducted an analysis on data gathered over a 17-year period. Using employment and medical records from 1990 through 2007, Bryngelson assessed how psychiatric sick leave influenced mortality in general and specific causes of death.

Bryngelson looked at the records of nearly one million Swedish workers and found that those who were on long-term psychiatric leave had a higher risk of dying prematurely than those who did not. The leading causes of death were cancer, cardiovascular disease, and suicide. Upon closer examination, Bryngelson found that leave extending past three months resulted in a risk of early death that was nearly one and a half times higher.

Although sick leave is intended to provide an opportunity for treatment and recovery, Bryngelson believes that in some cases, it may actually have a negative impact on individuals. The lack of work and socialization, and the decline in nutritious eating and exercise that often occurs during sick leave, could increase the risk of negative physical and psychological health outcomes.

Researchers found that interestingly, although suicides ranked high among mortality during sick leave, the rates of suicide declined during the 17-year study period. Bryngelson notes that this finding is in line with the general decline of suicides in Sweden during that same period, and believes that advances in medical approaches and psychological treatments could be partly responsible for that result. Further, increased risk of cancer among psychiatric sick leave recipients could indicate a predictive value and is an area that should be explored in depth in future work.

Bryngleson summed up her results by saying, “Our findings suggest that long-term sickness absence for psychiatric disorders may be used as a risk indicator for premature mortality.” This research underscores the importance of intervention and treatments designed to minimize the duration of sick leave time needed, especially for those on psychiatric sick leave.

Bryngelson, A., Åsberg, M., Nygren, Å., Jensen, I., Mittendorfer-Rutz, E. (2013). All-cause and cause-specific mortality after long-term sickness absence for psychiatric disorders: A prospective cohort study. PLoS ONE 8(6): e67887. doi:10.1371/journal.pone.0067887

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  • hendricks


    August 5th, 2013 at 10:35 PM

    being ill for long periods can really sap a person’s morale and mental energy in addition to the loss in physical strength.many reasons to believe that it leads to early mortality.steps need to be taken to keep up not just the health of such people but also their morale.only then will there be full recovery,a holistic recovery.

  • stressmom


    August 6th, 2013 at 2:44 PM

    But I am confused in general, because if someone does not take sick time then how are they supposed to get the in depth psychiatric care that they potentially need?

  • ronald


    August 7th, 2013 at 11:10 AM

    Stories like this really do scare people and tend to make them hesitant to ask for help. Maybe it is not the time away that leaads to early mortality. There are many other factors that could conincide that could lead to death rates that could be higher. We have read that heart disease could be higher in those with certain mental illnesses, and I am sure that there are other correlated physical and mental health issues that often go together. I think that the worst thing that someone could do when they are having problems with any aspect of their life is to NOT take time away from work and receive help. There are some issues that can be resolved while you are still on the job but the reality is that there are others that require a little time away and I am hoping that there will be more employers willing to reongnize this and allow their employees the freedom to get that help.

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