Comment on "The value of interdisciplinary treatment for sickness absence in chronic pain: A nationwide register‐based cohort study”

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.

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Association between early working life patterns, in publicly and privately owned companies, and the course of future sickness absence due to mental disorders: a cohort study in Catalonia (Spain)

BMJ Open ◽

10.1136/bmjopen-2020-040480 ◽

2021 ◽

Vol 11 (2) ◽

pp. e040480

Author(s):

Amaya Ayala-Garcia ◽

Laura Serra ◽

Monica Ubalde-Lopez

Keyword(s):

Cohort Study ◽

Mental Disorders ◽

Social Security ◽

Sickness Absence ◽

Multinomial Logistic Regression ◽

Working Life ◽

Men And Women ◽

Permanent Employment ◽

Life Patterns ◽

The Relationship

ObjectivesTo assess the relationship between early working life patterns, at privately and publicly held companies, and the course of sickness absence (SA) due to mental disorders.MethodsCohort study of workers aged 18–28 years, affiliated with the Spanish social security system, living in Catalonia, who had at least one episode of SA due to mental disorders between 2012 and 2014. Individual prior working life trajectories were reconstructed through sequence analysis. Optimal matching analysis was performed to identify early working life patterns by clustering similar individual trajectories. SA trajectories were identified using latent class growth modelling analysis. Finally, the relationship between early working life patterns and subsequent SA trajectories was assessed via multinomial logistic regression models.ResultsAmong both men and women, four labour market participation (LMP) patterns were identified: stable permanent employment (reference group), increasing permanent employment, fluctuating employment and delayed employment. Among women, an increasing permanent employment pattern in early working life was related to a decrease of accumulated SA days over time (adjusted OR (aOR) 2.08; 95% CI 1.18 to 3.66). In men, we observed a trend towards a middle stable accumulation of SA days in those with fluctuating employment (aOR 1.25, 95% CI 0.57 to 2.74) or delayed employment (aOR 1.79; 95% CI 0.59 to 5.41). In both men and women, an early working life in big companies was related to a more favourable SA trajectory.ConclusionsEarly LMP patterns characterised by an increasing stability—decreased number of transitions between temporary contracts and lack of social security coverage towards permanent contracts—were related to a better future SA course due to mental diagnosis.

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Pain memory in patients with chronic pain versus asymptomatic individuals: A prospective cohort study

European Journal of Pain ◽

10.1002/ejp.1621 ◽

2020 ◽

Vol 24 (9) ◽

pp. 1741-1751

Author(s):

Roy La Touche ◽

Alba Paris‐Alemany ◽

Luis Suso‐Martí ◽

Noelia Martín‐Alcocer ◽

Francisco Mercado ◽

...

Keyword(s):

Chronic Pain ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Pain Memory ◽

Asymptomatic Individuals

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0156 Predictors of sickness absence in pregnancy- a Danish cohort study

Occupational and Environmental Medicine ◽

10.1136/oemed-2014-102362.61 ◽

2014 ◽

Vol 71 (Suppl 1) ◽

pp. A19.3-A20

Author(s):

Mette Lausten Hansen ◽

Ane Marie Thulstrup ◽

Jette Kolding Kristensen ◽

Mette Juhl ◽

Cecilia Høst Ramlau-Hansen

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Danish Cohort ◽

In Pregnancy

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Future risk for disability pension among people with sickness absence due to otoaudiological diagnoses: a population-based cohort study with a 12-year follow-up

Scandinavian Journal of Public Health ◽

10.1177/1403494811399652 ◽

2011 ◽

Vol 39 (5) ◽

pp. 501-507 ◽

Cited By ~ 4

Author(s):

Klas Gustafsson ◽

Gunnel Backenroth-Ohsako ◽

Ulf Rosenhall ◽

Elisabeth Ternevall-Kjerulf ◽

Mats Ulfendahl ◽

...

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Disability Pension ◽

Population Based ◽

Future Risk ◽

Risk For Disability

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Chronic pain, opioid prescriptions, and mortality in Denmark: A population-based cohort study

Pain ◽

10.1016/j.pain.2014.07.006 ◽

2014 ◽

Vol 155 (12) ◽

pp. 2486-2490 ◽

Cited By ~ 64

Author(s):

Ola Ekholm ◽

Geana Paula Kurita ◽

Jette Hjsted ◽

Knud Juel ◽

Per Sjgren

Keyword(s):

Chronic Pain ◽

Cohort Study ◽

Population Based

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Process-outcome associations in an interdisciplinary treatment for chronic pain and comorbid mental disorders based on Acceptance and Commitment Therapy

Pain Medicine ◽

10.1093/pm/pnab102 ◽

2021 ◽

Author(s):

Ludwig Ohse ◽

Ronald Burian ◽

Eric Hahn ◽

Hannah Burian ◽

Thi Minh Tam Ta ◽

...

Keyword(s):

Chronic Pain ◽

Mental Disorders ◽

Clinical Outcomes ◽

Acceptance And Commitment Therapy ◽

Psychological Flexibility ◽

Post Treatment ◽

Interdisciplinary Treatment ◽

Pain Acceptance ◽

Acceptance And Commitment ◽

Comorbid Mental Disorders

Abstract Objective Numerous studies support the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain, yet little research has been conducted about its underlying mechanisms of change, especially regarding patients with comorbid mental disorders. The present investigation addressed this issue by examining associations of processes targeted by ACT (pain acceptance, mindfulness, psychological flexibility) and clinical outcomes (pain intensity, somatic symptoms, physical health, mental health, depression, general anxiety). Subjects Participants were 109 patients who attended an ACT-based interdisciplinary treatment program for chronic pain and comorbid mental disorders in a routine care psychiatric day hospital. Methods Pre- to post-treatment differences in processes and outcomes were examined with Wilcoxon signed-rank tests and effect size r. Associations between changes in processes and changes in outcomes were analyzed with correlation and multiple regression analyses. Results Pre- to post-treatment effect sizes were mostly moderate to large (r between |0.21| and |0.62|). Associations between changes in processes and changes in outcomes were moderate to large for both, bivariate correlations (r between |0.30| and |0.54|) and shared variances accounting for all three processes combined (R2 between 0.21 and 0.29). Conclusion The present investigation suggests that changes in pain acceptance, mindfulness and psychological flexibility are meaningfully associated with changes in clinical outcomes. It provides evidence on particular process-outcome associations that had not been investigated in this way before. The focus on comorbid mental disorders informs clinicians about a population of chronic pain patients that often has a severe course of illness and has seldom been studied.

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