Maria Melchior ^1*, Jane E. Ferrie ², Kristina Alexanderson ³, Marcel Goldberg ¹, Mika Kivimaki ², Archana Singh-Manoux ¹, Jussi Vahtera ⁴, Hugo Westerlund ⁵, Marie Zins ¹, Jenny Head ²

¹ INSERM
² University College London
³ Karolinska Institute
⁴ Finnish Institute of Occupational Health
⁵ Stockholm University

^* To whom correspondence should be addressed. E-mail: maria.melchior{at}inserm.fr.

	Abstract

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. Future research is required to explore the association between sickness, absence and depression.

Key Words: Epidemiology, Mental Health, Occupational Health, Prevention