Work Disability Trajectories Among Individuals with a Sick-Leave Spell Due to Depressive Episode ≥ 21 Days: A Prospective Cohort Study with 13-Month Follow Up.
Kristin Farrants, Emilie Friberg, Sara Sjölund and 1 others
PMID 29368028WHAT IT FOUND
Most people on sick leave for depression returned to work within four to nine months.
Those who stayed absent were more often unemployed, had prior sick leave, or used more healthcare. Trajectories varied widely, so early risk factors help predict who might need longer support.
Key findings
01Six distinct trajectories of work disability were identified, with the largest group (43%) decreasing to zero work disability days after four months.
02The 'constant high' work disability group was characterized by higher unemployment, lower education, and greater healthcare consumption, including inpatient care for suicide attempts.
03Employment status and the extent of sick leave (full-time vs part-time) at the start of the spell were the variables with the most explanatory power for trajectory group membership.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is exploratory and descriptive, identifying patterns but not testing interventions or causal mechanisms. Sick-leave diagnoses are based on medical certificates and may not accurately distinguish between first-onset and recurrent depression. The study only included spells lasting at least 21 days, excluding those with shorter absences. Work-related factors such as job demands, workplace support, and personality traits were not included in the data. The combination of gross days into net days for part-time absences might complicate the interpretation of the severity of disability.
Declared interests
The study was funded by Försäkringskassan (the Swedish Social Insurance Agency).
The easy way to misread this
Do not assume that specific clinical treatments caused these trajectories. This study describes patterns of absence and associated background factors like unemployment and prior sick leave, but it did not measure or test the effect of any specific therapy or intervention on these outcomes.