title: Mental health symptoms identify workers at risk of long-term sickness absence due to mental disorders: prospective cohort study with 2-year follow-up.
abstract: BACKGROUND
  Mental health problems are a leading cause of long-term sickness absence (LTSA). Workers at risk of mental LTSA should preferably be identified before they report sick. The objective of this study was to examine mental health symptoms as predictors of future mental LTSA in non-sicklisted workers.
  
  
  METHODS
  Prospective cohort study of 4877 non-sicklisted postal workers. Mental health symptoms were measured at baseline in November 2010 with the Four-Dimensional Symptom Questionnaire (distress and depressed mood) and Maslach's Burnout Inventory (fatigue). Mental health symptom scores were analyzed against incident mental LTSA retrieved from an occupational health register in 2011 and 2012. The area under the receiver operating characteristic curve (AUC) represented the ability of mental health symptom scores to discriminate between workers with and without mental LTSA during 2-year follow-up.
  
  
  RESULTS
  Complete cases analysis included 2782 (57 %) postal workers of whom 73 had mental LTSA during 2-year follow-up. Distress fairly (AUC = 0.75; 95 % CI 0.67-0.82) and both depressed mood (AUC = 0.64; 95 % CI 0.57-0.72) and fatigue (AUC = 0.61; 95 % CI 0.53-0.69) poorly discriminated between workers with and without mental LTSA during 2-year follow-up. The discriminative ability of distress did not improve by adding depressed mood and fatigue.
  
  
  CONCLUSIONS
  Measurement of distress sufficed to identify non-sicklisted postal workers at risk of future mental LTSA. The Four-Dimensional Symptom Questionnaire distress scale is a promising tool to screen working populations for of mental LTSA, which enables secondary preventive strategies.
authors.affiliation: ArboNed Occupational Health Service, Utrecht, The Netherlands. marieke.van.hoffen@arboned.nl.|Department of Epidemiology and Biostatistics, VU University Medical Center, VU University, Amsterdam, The Netherlands. marieke.van.hoffen@arboned.nl.|ArboNed, PO Box 11391, 3004 EJ, Rotterdam, The Netherlands. marieke.van.hoffen@arboned.nl.
authors.forename: Marieke F A
authors.initials: MF
authors.lastname: van Hoffen
authors.affiliation: ArboNed Occupational Health Service, Utrecht, The Netherlands. catelijne.joling@arboned.nl.
authors.forename: Catelijne I
authors.initials: CI
authors.lastname: Joling
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, VU University, Amsterdam, The Netherlands. mw.heymans@vumc.nl.
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, VU University, Amsterdam, The Netherlands. jwr.twisk@vumc.nl.
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
authors.affiliation: ArboNed Occupational Health Service, Utrecht, The Netherlands. corne.roelen@arboned.nl.|Department of Epidemiology and Biostatistics, VU University Medical Center, VU University, Amsterdam, The Netherlands. corne.roelen@arboned.nl.|Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. corne.roelen@arboned.nl.
authors.forename: Corné A M
authors.initials: CA
authors.lastname: Roelen
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015331:Cohort Studies; D003863:Depression; D005221:Fatigue; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008603:Mental Health; D008875:Middle Aged; D016272:Occupational Health; D011446:Prospective Studies; D012372:ROC Curve; D012306:Risk; D018582:Sick Leave / Q000706:statistics & numerical data; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult