Determinants of Sustainable Return to Work After Burnout or Depression: A Longitudinal Cohort Study

People with common mental disorders (CMDs) such as depression and burnout have a high recurrence rate of sickness absence (SA). Few studies have investigated the determinants of sustainable return to work (SRTW) after a CMD. The objective of this study was to identify determinants of SRTW, operationalized as recurrent SA and work ability after the return.

Participants were 148 employees that returned to work from April 2022 to January 2024 after CMD-related SA. In this prospective longitudinal cohort study, participants were followed up for one year after their return to work (RTW) by means of five questionnaires. Survival analysis and linear regression were carried out for recurrent SA and work ability outcomes, respectively.

By twelve months after initial RTW, 27.9% of patients experience recurrent SA, as estimated by the Kaplan-Meier method. Cox proportional hazards regression reveals that patients having a higher symptom severity of anxiety and depression at time of RTW have a significantly higher risk of recurrent SA (HR = 1.176, 95% CI [1.027-1.346], p = 0.019). At time of RTW, better work ability is linked to being married, higher self-efficacy, and greater controllability, while fixed shifts and higher depressive symptoms predict poorer work ability. Three months after RTW, resilience emerges as a positive predictor, whereas at six and nine months, depressive symptoms and controllability remain significant predictors, respectively.

Symptoms of depression and anxiety at the start of RTW influence recurrent SA and work ability thereafter for people suffering from a CMD.