title: Optimal cutoff values of WHO-HPQ presenteeism scores by ROC analysis for preventing mental sickness absence in Japanese prospective cohort.
abstract: OBJECTIVE
  Sickness absence due to mental disease in the workplace has become a global public health problem. Previous studies report that sickness presenteeism is associated with sickness absence. We aimed to determine optimal cutoff scores for presenteeism in the screening of the future absences due to mental disease.
  
  
  METHODS
  A prospective study of 2195 Japanese employees from all areas of Japan was conducted. Presenteeism and depression were measured by the validated Japanese version of the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) and K6 scale, respectively. Absence due to mental disease across a 2-year follow-up was surveyed using medical certificates obtained for work absence. Socioeconomic status was measured via a self-administered questionnaire. Receiver operating curve (ROC) analysis was used to determine optimal cutoff scores for absolute and relative presenteeism in relation to the area under the curve (AUC), sensitivity, and specificity.
  
  
  RESULTS
  The AUC values for absolute and relative presenteeism were 0.708 (95% CI, 0.618-0.797) and 0.646 (95% CI, 0.546-0.746), respectively. Optimal cutoff scores of absolute and relative presenteeism were 40 and 0.8, respectively. With multivariate adjustment, cohort participants with our proposal cutoff scores for absolute and relative presenteeism were significantly more likely to be absent due to mental disease (OR = 4.85, 95% CI: 2.20-10.73 and OR = 5.37, 95% CI: 2.42-11.93, respectively). The inclusion or exclusion of depressive symptoms (K6≥13) at baseline in the multivariate adjustment did not influence the results.
  
  
  CONCLUSIONS
  Our proposed optimal cutoff scores of absolute and relative presenteeism are 40 and 0.8, respectively. Participants who scored worse than the cutoff scores for presenteeism were significantly more likely to be absent in future because of mental disease. Our findings suggest that the utility of presenteeism in the screening of sickness absence due to mental disease would help prevent such an absence.
authors.affiliation: Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan; Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyaki
authors.affiliation: Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yixuan
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Akizumi
authors.initials: A
authors.lastname: Tsutsumi
authors.affiliation: Department of Mental Health, Tokyo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.affiliation: Department of Mental Health, Tokyo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Shimazu
authors.affiliation: Health Administration and Psychosocial Factor Research Group, National Institute of Occupational Safety and Health, Kanagawa, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Akiomi
authors.initials: A
authors.lastname: Inoue
authors.affiliation: Department of Health Policy and Management, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kurioka
authors.affiliation: Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D000069597:Presenteeism; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012923:Social Class; D011795:Surveys and Questionnaires; D017132:Workplace; D014944:World Health Organization; D055815:Young Adult