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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.142273v1 99/8/1417    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Melchior, M. Articles by Head, J. Search for Related Content PubMed PubMed Citation Articles by Melchior, M. Articles by Head, J. Related Collections Epidemiology Mental Health Occupational Health Prevention

Maria Melchior, ScD, Jane E. Ferrie, PhD, Kristina Alexanderson, PhD, Marcel Goldberg, MD, PhD, Mika Kivimaki, PhD, Archana Singh-Manoux, PhD, Jussi Vahtera, MD, Hugo Westerlund, PhD, Marie Zins, MD and Jenny Head, MSc

Maria Melchior, Marcel Goldberg, Archana Singh-Manoux, and Marie Zins are with the National Institutes of Health and Medical Research (INSERM U687), Villejuif, France. Jane E. Ferrie, Mika Kivimaki, Archana Singh-Manoux, and Jenny Head are with the International Institute for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London, United Kingdom. Kristina Alexanderson is with the Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Jussi Vahtera is with the Finnish Institute of Occupational Health, Turku, Finland. Hugo Westerlund is with the Stress Research Institute, Stockholm University, Stockholm.

Correspondence: Requests for reprints should be sent to Maria Melchior, ScD, INSERM U687, Hôpital Paul-Brousse, 16 avenue Paul Vaillant-Couturier, Bâtiment 15/16, 94807 Villejuif Cédex, France (e-mail: maria.melchior{at}inserm.fr).

Objectives. We tested the hypothesis that sickness absence from work predicts workers' risk of later depression.

Methods. Study participants (n = 7391) belonged to the French GAZEL cohort of employees of the national gas and electricity company. Sickness absence data (1996–1999) were obtained from company records. Participants' depression in 1996 and 1999 was assessed with the Center for Epidemiologic Studies–Depression (CES-D) scale. The analyses were controlled for baseline age, gender, marital status, occupational grade, tobacco smoking status, alcohol consumption, subthreshold depressive symptoms, and work stress.

Results. Among workers who were free of depression in 1996, 13% had depression in 1999. Compared with workers with no sickness absence during the study period, those with sickness absence were more likely to be depressed at follow-up (for 1 period of sickness absence, fully adjusted odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.28, 1.82; for 2 or more periods, fully adjusted OR = 1.95, 95% CI = 1.61, 2.36). Future depression was predicted both by psychiatric and nonpsychiatric sickness absence (fully adjusted OR = 3.79 [95% CI = 2.81, 5.10] and 1.41 [95% CI = 1.21, 1.65], respectively).

Conclusions. Sickness absence records may help identify workers vulnerable to future depression.