title: Predictors of recurrent sickness absence due to depressive disorders--a Delphi approach involving scientists and physicians.
abstract: BACKGROUND
  Depression is a common and highly recurrent mental disorder that is accompanied by poor functioning at home and at work. Not all depressed employees report sick and little is known about variables associated with sickness absence (SA) due to depression. Recurrent SA due to depression tends to marginalize employees from the workforce and exclude them from social participation. Therefore, this study sought group consensus on factors predicting recurrent SA due to depression.
  
  
  RESULTS
  23 scientists in the field of work and mental health and 23 physicians with expertise in assessing work disability were invited for a Delphi study. Sixty-seven factors retrieved from the literature were scored for their impact on the recurrence of SA due to depression, range 1 (no impact) to 10 (very high impact) in two Delphi rounds. The third Delphi round addressed the assessability and modifiability of elected predictors. Group consensus was defined as 75% agreement. In the first round (response 78%), group consensus was reached on a high impact of 13 factors on recurrent SA due to depression. The second round (response 79%) added another 8 factors with high impact on recurrent SA due to depression. The panelists were of the opinion that stressful life and work events, age at first diagnosis, duration of the last depressive episode, anxiety, lifetime number of depressive episodes, and psychological work demands were readily assessable in consultation with patients. Furthermore, work factors, particularly decision latitude, psychological job demands, and commitment to work, were recognized as modifiable.
  
  
  CONCLUSIONS
  Although results have to be validated with further quantitative research, physicians may identify employees at risk of recurrent SA due to depression and may support them to adjust their work aimed at increasing commitment to work and preventing future SA due to depression.
authors.affiliation: 365/Occupational Health Service Utrecht, Utrecht, The Netherlands. giny.norder@365.nl
authors.forename: Giny
authors.initials: G
authors.lastname: Norder
authors.forename: Corné A M
authors.initials: CA
authors.lastname: Roelen
authors.forename: Willem
authors.initials: W
authors.lastname: van Rhenen
authors.forename: Jan
authors.initials: J
authors.lastname: Buitenhuis
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
mesh_terms: D000041:Absenteeism; D001008:Anxiety Disorders / Q000523:psychology*; D032921:Consensus; D003866:Depressive Disorder / Q000523:psychology*; D006801:Humans; D059232:Laboratory Personnel; D010820:Physicians; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data* / Q000639:trends; D012931:Social Environment; D011795:Surveys and Questionnaires