title: Does sickness absence due to psychiatric disorder predict cause-specific mortality? A 16-year follow-up of the GAZEL occupational cohort study.
abstract: Mental disorders are a frequent cause of morbidity and sickness absence in working populations; however, the status of psychiatric sickness absence as a predictor of mortality is not established. The authors tested the hypothesis that psychiatric sickness absence predicts mortality from leading medical causes. Data were derived from the French GAZEL cohort study (n = 19,962). Physician-certified sickness absence records were extracted from administrative files (1990-1992) and were linked to mortality data from France's national registry of mortality (1993-2008, mean follow-up: 15.5 years). Analyses were conducted by using Cox regression models. Compared with workers with no sickness absence, those absent due to psychiatric disorder were at increased risk of cause-specific mortality (hazard ratios (HRs) adjusted for age, gender, occupational grade, other sickness absence-suicide: 6.01, 95% confidence interval (CI): 3.07, 11.75; cardiovascular disease: 1.84, 95% CI: 1.10, 3.08; and smoking-related cancer: 1.65, 95% CI: 1.07, 2.53). After full adjustment, the excess risk of suicide remained significant (HR = 5.13, 95% CI: 2.60, 10.13) but failed to reach statistical significance for fatal cardiovascular disease (HR = 1.59, 95% CI: 0.95, 2.66) and smoking-related cancer (HR = 1.31, 95% CI: 0.85, 2.03). Psychiatric sickness absence records could help identify individuals at risk of premature mortality and serve to monitor workers' health.
authors: Centre de Recherche en Epidémiologie et Santé des Populations/UMRS-1018, Epidémiologie des Déterminants Professionnels et Sociaux de la Santé, Inserm, Hôpital Paul-Brousse, Villejuif, France. maria.melchior@inserm.fr
authors: Maria
authors: M
authors: Melchior
authors: Jane E
authors: JE
authors: Ferrie
authors: Kristina
authors: K
authors: Alexanderson
authors: Marcel
authors: M
authors: Goldberg
authors: Mika
authors: M
authors: Kivimaki
authors: Archana
authors: A
authors: Singh-Manoux
authors: Jussi
authors: J
authors: Vahtera
authors: Hugo
authors: H
authors: Westerlund
authors: Marie
authors: M
authors: Zins
authors: Jenny
authors: J
authors: Head
mesh_terms: D000041:Absenteeism; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000401:mortality; D009790:Occupations / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data