title: Mental health in the workplace: using the ICF to model the prospective associations between symptoms, activities, participation and environmental factors.
abstract: OBJECTIVE
  This prospective study used the framework of ICF components to investigate the magnitude and direction of association between body functions (depression/anxiety symptoms), activity (limitations in work activities), participation (sickness absence), and environment (psychosocial aspects) in the workplace setting.
  
  
  METHODS
  A cohort of employees completed a self-report survey at baseline and 6 months follow-up, with analysis restricted to those with at least one health condition (n = 204). Self-report measures of depression/anxiety symptoms, limitations in work activities, sickness absences, and psychosocial work environment were mapped to the corresponding ICF component. The prospective association between these components was modelled using relative risks (RR) estimated from log-binomial regression.
  
  
  RESULTS
  Depression/anxiety symptoms were more likely to be an outcome of other ICF components, rather than a risk factor. Sickness absence, limitations in work activities, and work environment all conferred a greater than two-fold risk of depression/anxiety symptoms 6 months later.
  
  
  CONCLUSIONS
  The ICF offers a valuable approach to understanding the contextual influences on employee mental health and work disability. Further application of the ICF framework to mental health should improve the environmental components and encourage a wider adoption of the ICF by mental health researchers and practitioners.
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Australia. kristy.sanderson@utas.edu.au
authors.forename: Kristy
authors.initials: K
authors.lastname: Sanderson
authors.forename: Jan
authors.initials: J
authors.lastname: Nicholson
authors.forename: Nick
authors.initials: N
authors.lastname: Graves
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tilse
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000145:classification* / Q000209:etiology; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D012944:Social Support; D017132:Workplace / Q000523:psychology*; D055815:Young Adult