title: Reduction in personnel and long-term sickness absence for psychiatric disorders among employees in Swedish county councils: an ecological population-based study.
abstract: OBJECTIVE
  The aim was to examine whether staff downsizing was related to long-term psychiatric sickness absence.
  
  
  METHODS
  We used aggregate data on sickness absence from AFA insurance, as well as information on staff numbers from the Swedish Association of Local Authorities and Regions. Bootstrap regression analyses were used to elucidate whether there was a relationship between reduction in personnel and changes in sickness rates.
  
  
  RESULTS
  A staff reduction of 1% increased the sickness rate, on average, by 9%. The associations were similar in men and women as well as in different age groups, although statistical significance was only reached in the groups of women and middle-aged employees.
  
  
  CONCLUSIONS
  Our findings suggest that downsizing may be related to subsequent increases in psychiatric sickness absence. The association appeared after a time-delay of several years.
authors.affiliation: Department of Clinical Sciences, Division of Insurance Medicine, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden. anna.bryngelson@ki.se
authors.forename: Anna
authors.initials: A
authors.lastname: Bryngelson
authors.forename: Ellenor
authors.initials: E
authors.lastname: Mittendorfer-Rutz
authors.forename: Johan
authors.initials: J
authors.lastname: Fritzell
authors.forename: Marie
authors.initials: M
authors.lastname: Asberg
authors.forename: Ake
authors.initials: A
authors.lastname: Nygren
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D016208:Databases, Factual; D004651:Employment / Q000523:psychology; D005260:Female; D006076:Government; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D020415:Personnel Downsizing / Q000523:psychology*; D012044:Regression Analysis; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D017132:Workplace / Q000523:psychology; D055815:Young Adult