title: Insecure social relations at work and long-term sickness absence due to burnout and other mental diagnoses.
abstract: OBJECTIVE
  The association between diagnosis and psychosocial work factors in a sickness absent population was examined in order to test the existence of a previously suggested hypothesis of "the burnout staircase", a seven step process prior to the long-term sickness absence due to burnout starting with reorganisations followed by insecure social bonds affecting the work situation as well as trust in oneself and others.
  
  
  METHODS
  The study population comprised of 2055 employed sick-listed persons (1414 women, 641 men), a sub sample derived from the 2002 national Swedish survey on health, working conditions, life situation and sick-listing.
  
  
  METHODS
  Through multinomial logistic regression it was analysed if experiences of the different steps in the burnout staircase increased the probability of burnout compared to other medical diagnoses.
  
  
  RESULTS
  The hypothesis was supported. The study revealed strong and significant associations between having experienced reorganisations, insecure social relations fraught with conflicts, incompatible demands, lack of trust and diminished self-esteem and burnout. This was true for both women and men. Strong and significant associations were found also between each step studied and other mental diagnoses for men.
  
  
  CONCLUSIONS
  More studies are needed to further test the hypothesis.
authors.affiliation: Karlstad University, Karlstad, Sweden. ullabritt.eriksson@kau.se
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Eriksson
authors.forename: Lars-Gunnar
authors.initials: LG
authors.lastname: Engström
authors.forename: Bengt
authors.initials: B
authors.lastname: Starrin
authors.forename: Staffan
authors.initials: S
authors.lastname: Janson
mesh_terms: D000041:Absenteeism; D000328:Adult; D002055:Burnout, Professional / Q000523:psychology*; D003220:Conflict, Psychological; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D035502:Trust / Q000523:psychology; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000458:organization & administration / Q000523:psychology; D055815:Young Adult