Reuters UK: Sick leave for mental illness linked to early death

By Amy Norton

NEW YORK (Reuters Health) - People who need to take time off from work for a mental health problem may live shorter lives than those in better psychiatric health, a new study suggests.

Researchers found that among nearly 20,000 French workers they followed, those who'd taken at least 1 week's sick leave for a mental health disorder had a higher death rate over 14 years.

At the outset, 41 percent of the workers -- all public utility employees -- had taken at least 1 week's sick leave over the past 3 years. Those who'd taken time off specifically for depression or other mental health disorders were one quarter to one third more likely to die over the study period than workers with no mental-health absences.

"Basically the message is that workers with medically certified absences for mental diagnoses should be considered a population at a higher risk of fatal disease," lead researcher Dr. Jane E. Ferrie, of the University College London in the UK, told Reuters Health.

She stressed, however, that the findings point to a relatively higher death rate in this group as a whole -- and that does not mean that any one person with a mental health disorder has an unusually high risk of early death.

When studies observe large populations over time to look for patterns, the results cannot be used to "infer risk at the level of the individual," Ferrie explained.

The findings, published in the Journal of Epidemiology and Community Health, are based on 19,235 public utility employees (5271 female) who were part of long-range health study. The researchers used employment records to verify any medically certified work absences the employees had between 1990 and 1992. (French law requires workers to get a medical certificate from their doctors for each day of sick leave.)

Between 1993 and 2007, there were 902 deaths among the study participants. Those who'd taken 7 days or more off from work for a mental health disorder had a higher risk of death, even when their age and type of job were taken into account.

With the exception of extreme cases, mental health problems do not, in themselves, kill people, Ferrie pointed out. Instead, she explained, poor mental health is often connected to poor physical health.

On one hand, physical conditions may lead to depression or other mental health problems, Ferrie noted. On the other, psychiatric conditions may directly impair physical health, possibly by affecting the nervous and hormonal systems.

SOURCE: Journal of Epidemiology and Community Health, November 25, 2008.

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