Psychological distress, fatigue and long-term sickness absence: prospective results from the Maastricht Cohort Study

J Occup Environ Med. 2005 Sep;47(9):941-7. doi: 10.1097/01.jom.0000172865.07397.9a.


Objective: Little is known about psychological distress as a risk factor for the onset of long-term sickness absence and even less about the influence of fatigue in this relationship.

Methods: We examined the relationship between psychological distress and the onset of long-term sickness absence during 18 months of follow-up while considering fatigue. Analyses were based on 6403 employees participating in the Maastricht Cohort Study.

Results: Psychological distress was related to the onset of long-term sickness absence (women relative risk 1.45, 95% confidence interval = 1.23-1.72; men 1.33, 1.21-1.46). Adjustment for fatigue weakened the associations, particularly in women. Caseness analyses revealed different effects of psychological distress and fatigue in the onset of long-term sickness absence in men and women.

Conclusion: The findings underline the need for interventions aiming at psychological distress and, depending on the gender, also at fatigue, to reduce the risk of long-term sickness absence.

MeSH terms

  • Absenteeism*
  • Adult
  • Cohort Studies
  • Epidemiologic Studies
  • Fatigue
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Risk Factors
  • Sick Leave
  • Stress, Psychological*
  • Workplace