a lifecourse approach to long-term sickness absence—a cohort study长期患病的lifecourse方法如果没有队列研究.pdfVIP

A Lifecourse Approach to Long-Term Sickness Absence— A Cohort Study 1 2 2 1 Max Henderson *, Charlotte Clark , Stephen Stansfeld , Matthew Hotopf 1 Department of Psychological Medicine, King’s College London Institute of Psychiatry, London, United Kingdom, 2 Centre for Psychiatry, Wolfson Institute for Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom Abstract Background: Most research on long-term sickness absence has focussed on exposure to occupational psychosocial risk factors such as low decision latitude. These provide an incomplete explanation as they do not account for other relevant factors. Such occupational risk factors may be confounded by social or temperamental risk factors earlier in life. Methods: We analysed data from the 1958 British Birth Cohort. Long-term sickness absence was defined as receipt of Incapacity Benefit/Severe Disablement Allowance at age 42. In those in employment aged 33 we examined the effects of psychological distress, musculoskeletal symptoms, and low decision latitude. These were then adjusted for IQ, educational attainment, and the presence of early life somatic and neurotic symptoms. Results: Low decision latitude predicted subsequent long-term absence, and this association remained, albeit reduced, following adjustment for psychological distress and musculoskeletal symptoms at age 33. Low decision latitude was no longer associated with long-term absence when IQ and educational attainment were included. Adjusting for early life somatic and neurotic symptoms had little impact. Discussion: A greater understanding of the ways in which occupational risk factors interact with individu