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Predictors of sustained return to work after sick leave due to mental disorders
Bruna Roberta Muntanelli1, João Silvestre Silva-Junior1
1Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Abstract:
Mental disorders are brain dysfunctions that impair occupational performance and are associated with prolonged absences from work and a higher likelihood of relapse. Sustained return to work refers to resuming either original or modified job duties for at least 1 month without recurrent sick leave. This outcome is linked to improved health indicators among workers and reduced socioeconomic burdens resulting from prolonged absences. This study aimed to identify predictors of sustained return to work following sick leave due to mental disorders, based on a literature review conducted in the MEDLINE/PubMed, Scopus, and SciELO databases, including articles published up to July 2023. Quantitative studies were included if they clearly defined sustained return to work and involved workers on leave due to mental disorders. Predictors were categorized into sociodemographic, clinical, psychosocial, and occupational domains. Positive predictors of sustained return to work included favorable expectations regarding the sick leave, self-efficacy, supervisor support, notification systems for prolonged absences, and partial sick leave arrangements. Negative predictors included a greater number of mental disorder episodes, older age, persistent symptoms, job strain, psychiatric/psychological follow-up, medication use, extended duration of leave, employment in small enterprises or specific sectors, and higher educational attainment. Female sex emerged as an inconsistent predictor, with mixed findings. In conclusion, sustained return to work is influenced by multiple factors and results from the interaction between individual and contextual elements. Therefore, collaboration among all stakeholders is essential for successful worker reintegration.
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