Development of Prediction Models for Sickness Absence Due to Mental Disorders in the General Working Population
Purpose This study investigated if and how occupational health survey variables can be used to identify workers at risk of long-term sickness absence (LTSA) due to mental disorders. Methods Cohort study including 53,833 non-sicklisted participants in occupational health surveys between 2010 and 2013. Twenty-seven survey variables were included in a backward stepwise logistic regression analysis with mental LTSA at 1-year follow-up as outcome variable. The same variables were also used for decision tree analysis. Discrimination between participants with and without mental LTSA during follow-up was investigated by using the area under the receiver operating characteristic curve (AUC); the AUC was internally validated in 100 bootstrap samples. Results 30,857 (57%) participants had complete data for analysis; 450 (1.5%) participants had mental LTSA during follow-up. Discrimination by an 11-predictor logistic regression model (gender, marital status, economic sector, years employed at the company, role clarity, cognitive demands, learning opportunities, co-worker support, social support from family/friends, work satisfaction, and distress) was AUC = 0.713 (95% CI 0.692–0.732). A 3-node decision tree (distress, gender, work satisfaction, and work pace) also discriminated between participants with and without mental LTSA at follow-up (AUC = 0.709; 95% CI 0.615–0.804). Conclusions An 11-predictor regression model and a 3-node decision tree equally well identified workers at risk of mental LTSA. The decision tree provides better insight into the mental LTSA risk groups and is easier to use in occupational health care practice.
KeywordsDecision-tree analysis Health surveys Logistic regression Mental health ROC analysis
The study was not funded.
Compliance with Ethical Standards
Conflicts of interest
The authors declare that they have no conflict of interest.
The Medical Ethics Committee of the University Medical Center Groningen reviewed the study and granted ethical clearance.
All occupational health survey participants agreed to the use of their questionnaire results for scientific research.
- 1.Organization of Economic Cooperation and Development. Fit mind, fit job. From evidence to practice in mental health and work. Paris: OECD Publishing; 2015.Google Scholar
- 10.Airaksinen J, Jokela M, Virtanen M, Oksanen T, Koskenvuo M, Pentti J, Vahtera J, Kivimäki M. Prediction of long-term absence due to sickness absence in employees: development and validation of a multifactorial risk score in two cohort studies. Scand J Work Environ Health. 2018;44(3):274–282.CrossRefGoogle Scholar
- 14.Moons KG, Altman DG, Reitsma JB, Ioannidis JP, Macaskill P, Steyerberg EW, Vickers AJ, Ransohoff DF, Collins GS. Transparent reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): explanation and elaboration. Ann Intern Med. 2015;162(1):W1–W73.CrossRefGoogle Scholar
- 22.Terluin B, van Marwijk HW, Adèr HJ, de Vet HC, Penninx BW, Hermens ML, van Boeijen CA, van Balkom AJ, van der Klink JJ, Stalman WA. The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization. BMC Psychiatry. 2006;6(1):34.CrossRefGoogle Scholar