Psychological distress, fatigue and long-term sickness absence: prospective results from the Maastricht Cohort Study.
OBJECTIVE
Little is known about psychological distress as a risk factor for the onset of long-term sickness absence and even less about the influence of fatigue in this relationship.


METHODS
We examined the relationship between psychological distress and the onset of long-term sickness absence during 18 months of follow-up while considering fatigue. Analyses were based on 6403 employees participating in the Maastricht Cohort Study.


RESULTS
Psychological distress was related to the onset of long-term sickness absence (women relative risk 1.45, 95% confidence interval = 1.23-1.72; men 1.33, 1.21-1.46). Adjustment for fatigue weakened the associations, particularly in women. Caseness analyses revealed different effects of psychological distress and fatigue in the onset of long-term sickness absence in men and women.


CONCLUSIONS
The findings underline the need for interventions aiming at psychological distress and, depending on the gender, also at fatigue, to reduce the risk of long-term sickness absence.
Bültmann
Ute
U
National Institute of Occupational Health, Copenhagen, Denmark. utb@ami.dk
Huibers
Marcus J H
MJ
van Amelsvoort
Ludovic P G M
LP
Kant
Ijmert
I
Kasl
Stanislav V
SV
Swaen
Gerard M H
GM
D000041:Absenteeism; D000328:Adult; D015331:Cohort Studies; D016021:Epidemiologic Studies; D005221:Fatigue; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D018582:Sick Leave; D013315:Stress, Psychological; D017132:Workplace