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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