Does Sickness Absence Due to Psychiatric Disorder Predict Cause-specific Mortality? A 16-Year Follow-up of the GAZEL Occupational Cohort Study
Does Sickness Absence Due to Psychiatric Disorder Predict Cause-specific Mortality? A 16-Year Follow-up of the GAZEL Occupational Cohort Study
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DOI：
10.1093/aje/kwq186
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发表时间：
2010-09-15
影响因子：
5
通讯作者：
Head, Jenny
中科院分区：
文献类型：
--
作者：
Melchior, Maria;Ferrie, Jane E.;Head, Jenny
精神障碍是工作人口发病和病假的常见原因;然而，精神病缺勤作为死亡率预测因素的地位尚未确立。作者检验了精神病缺席预测主要医学原因死亡率的假设。数据来自法国GAZEL队列研究（n = 19，962）。医生证明的病假记录从行政档案中提取（1990-1992年），并与法国国家死亡率登记处的死亡率数据相关联（1993-2008年，平均随访时间：15.5年）。采用考克斯回归模型进行分析。与没有因病缺勤的工人相比，因精神疾病缺勤的工人的死因特异性死亡风险增加（校正年龄、性别、职业等级、其他疾病缺勤-自杀的风险比（HR）：6.01，95% CI：3.07，11.75;心血管疾病：1.84，95% CI：1.10，3.08;吸烟相关癌症：1.65，95%CI：1.07，2.53）。经过充分调整后，自杀的超额风险仍然显着（HR = 5.13，95%CI：2.60，10.13），但对于致命性心血管疾病（HR = 1.59，95%CI：0.95，2.66）和吸烟相关癌症（HR = 1.31，95%CI：0.85，2.03）未能达到统计学显著性。精神病缺勤记录可帮助确定有过早死亡风险的个人，并有助于监测工人的健康状况。
Mental disorders are a frequent cause of morbidity and sickness absence in working populations; however, the status of psychiatric sickness absence as a predictor of mortality is not established. The authors tested the hypothesis that psychiatric sickness absence predicts mortality from leading medical causes. Data were derived from the French GAZEL cohort study (n = 19,962). Physician-certified sickness absence records were extracted from administrative files (1990-1992) and were linked to mortality data from France's national registry of mortality (1993-2008, mean follow-up: 15.5 years). Analyses were conducted by using Cox regression models. Compared with workers with no sickness absence, those absent due to psychiatric disorder were at increased risk of cause-specific mortality (hazard ratios (HRs) adjusted for age, gender, occupational grade, other sickness absence-suicide: 6.01, 95% confidence interval (CI): 3.07, 11.75; cardiovascular disease: 1.84, 95% CI: 1.10, 3.08; and smoking-related cancer: 1.65, 95% CI: 1.07, 2.53). After full adjustment, the excess risk of suicide remained significant (HR = 5.13, 95% CI: 2.60, 10.13) but failed to reach statistical significance for fatal cardiovascular disease (HR = 1.59, 95% CI: 0.95, 2.66) and smoking-related cancer (HR = 1.31, 95% CI: 0.85, 2.03). Psychiatric sickness absence records could help identify individuals at risk of premature mortality and serve to monitor workers' health.