title: Time to recurrence of mental health-related absence from work.
abstract: BACKGROUND
  It is unclear when occupational health providers should re-evaluate workers after mental health-related absences from work.
  
  
  OBJECTIVE
  To investigate the time to recurrence of mental health-related absences, stratified by International Classification of Diseases-Tenth Revision (ICD-10) diagnostic categories.
  
  
  METHODS
  A 10-year observational study of workers employed at a steel mill. Sickness absence data were retrieved from an occupational health register. Mental health-related absences were defined as absence due to emotional disturbance or mental and behavioural disorders. The first mental health-related absence since baseline was called the index episode. Recurrences were defined as mental health-related absences occurring >28 days after recovery from the index episode. The frequency of recurrent mental health-related absence was assessed by the recurrence density (RD) per 1000 person-years. The time to recurrent mental health-related absence was investigated by Kaplan-Meier survival analysis.
  
  
  RESULTS
  Of 15461 workers, 391 had recurrent mental health-related absences. RD was 30.5, 34.3, 29.9 and 37.7 per 1000 person-years after index episodes due to emotional disturbance, mood disorders, neurotic disorders and other psychiatric disorders, respectively. RDs did not differ across ICD-10 diagnostic categories. The median time to recurrent mental health-related absence was 15.2 months [95% confidence interval (CI) 12.6-17.7] and was shortest for mood disorders (5.2, 95% CI 1.4-8.9 months) and specific psychiatric disorders (5.3, 95% CI 1.0-13.1 months).
  
  
  CONCLUSIONS
  Based on this observational study, we suggest that occupational and primary health care providers consider reviewing the mental health status of workers 6 months after recovery from mental health-related absence.
authors.affiliation: ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands, Department of Health Sciences, Division of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands, giny.norder@arboned.nl.
authors.forename: G
authors.initials: G
authors.lastname: Norder
authors.affiliation: ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Hoedeman
authors.affiliation: ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: de Bruin
authors.affiliation: ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands, Center for Human Resource, Organization and Management Effectiveness, Business University Nyenrode, 3620 AC Breukelen, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: van Rhenen
authors.affiliation: ArboNed Occupational Health Service, 3508 AB Utrecht, The Netherlands, Department of Health Sciences, Division of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands, Department of Epidemiology and Biostatistics, VU Medical Center, VU University, 1007 MB Amsterdam, The Netherlands.
authors.forename: C A M
authors.initials: CA
authors.lastname: Roelen
mesh_terms: D000041:Absenteeism; D004651:Employment; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders; D008603:Mental Health; D019964:Mood Disorders; D016272:Occupational Health; D009786:Occupational Health Services; D009790:Occupations; D012008:Recurrence; D062707:Return to Work; D012307:Risk Factors; D012737:Sex Factors; D018582:Sick Leave; D013232:Steel; D014937:Work
chemical_list: D013232:Steel
keywords: Absenteeism; ICD-10; mental health; occupational; psychiatric disorders; recurrent sickness absences; sick leave.