Psychological distress screener for risk of future mental sickness absence in non-sicklisted employees

Eur J Public Health. 2016 Jun;26(3):510-2. doi: 10.1093/eurpub/ckw034. Epub 2016 Mar 31.


Background: Recently, a three-item screener, derived from the 16-item distress scale of the Four-Dimensional Symptom Checklist (4DSQ), was used to measure psychological distress in sicklisted employees. The aim of the present study was to investigate the ability of the 16-item distress scale and three-item distress screener to identify non-sicklisted employees at risk of sickness absence (SA) due to mental disorders.

Methods: Prospective cohort study including 4877 employees working in distribution and transport. The 4DSQ distress scale was distributed at baseline in November 2010. SA diagnosed within the International Classification of Diseases -10 chapter F was defined as mental SA and retrieved from an occupational health register during 2-year follow-up. The area under the receiver operating characteristic curve (AUC) was used to discriminate between workers with ('cases') and without ('non-cases') mental SA during follow-up.

Results: A total of 2782 employees (57%) were included in complete cases analysis; 73 employees had mental SA during 2-year follow-up. Discrimination between cases and non-cases was similar for the 16-item distress scale (AUC = 0.721; 95% CI, 0.622-0.823) and the three-item screener (AUC = 0.715; 95% CI, 0.615-0.815).

Conclusion: Healthcare providers could use the three-item distress screener to identify non-sicklisted employees at risk of future mental SA.

MeSH terms

  • Absenteeism*
  • Adult
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology
  • Occupational Health / statistics & numerical data*
  • Prospective Studies
  • Registries
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Sick Leave / statistics & numerical data*
  • Stress, Psychological / diagnosis*
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires*