title: Are fatigue, depression and anxiety associated with labour market participation among patients diagnosed with haematological malignancies? A prospective study.
abstract: OBJECTIVE
  The objectives of this study are to examine levels of fatigue, depression and anxiety following diagnosis of a haematological malignancy, to determine the incidence of return to work (RTW) and long-term sickness absence (LTSA) during 1-year follow-up and to examine whether fatigue, depression and anxiety are associated with RTW and LTSA in this group of cancer patients.
  
  
  METHODS
  Questionnaire-based data on fatigue, depression and anxiety were obtained at baseline. In all, 196 patients returned the questionnaire. Of these, 106 patients were on sick leave and 90 patients were working. They were all followed prospectively for 1 year using register-based data on labour market participation.
  
  
  RESULTS
  At baseline, high levels of fatigue, depression and anxiety were more prevalent among sickness absent patients than in those working. Half of the sickness absent patients returned to work during follow-up, and only 10 (11%) working patients experienced LTSA. Sickness absent patients with highest scores of physical fatigue were less likely to RTW than those with lowest scores (RRadj 0.43, 95% CI 0.23-0.78). Similar, we found an association between symptoms of anxiety and RTW (p = 0.048). This association was though non-significant in multivariable analyses (p = 0.068). No significant association was found between depression and RTW.
  
  
  CONCLUSIONS
  Half of sickness absent patients returned to work, and only a few of working patients experienced LTSA during follow-up. Patients reporting high levels of physical fatigue were less likely to RTW. There was a similar tendency for anxiety, whereas we found no association between depression and RTW. Larger prospective studies are needed.
authors.affiliation: Department of Haematology, Aarhus University Hospital, Aarhus, Denmark; Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Trine A
authors.initials: TA
authors.lastname: Horsboel
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
authors.forename: Claus V
authors.initials: CV
authors.lastname: Nielsen
authors.forename: Bendt
authors.initials: B
authors.lastname: Nielsen
authors.forename: Niels T
authors.initials: NT
authors.lastname: Andersen
authors.forename: Annette
authors.initials: A
authors.lastname: de Thurah
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D008297:Male; D005222:Mental Fatigue / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D011446:Prospective Studies; D062707:Return to Work / Q000523:psychology* / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: cancer; fatigue; mental health; oncology; work