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Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs.

https://arctichealth.org/en/permalink/ahliterature299213
Source
Scand J Public Health. 2019 Mar; 47(2):127-136
Publication Type
Journal Article
Date
Mar-2019
Author
Lisa Mather
Victoria Blom
Gunnar Bergström
Pia Svedberg
Author Affiliation
1 Division of Insurance Medicine, Karolinska Institutet, Sweden.
Source
Scand J Public Health. 2019 Mar; 47(2):127-136
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Female
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Prospective Studies
Sick Leave - statistics & numerical data
Sweden - epidemiology
Twins - psychology - statistics & numerical data
Young Adult
Abstract
The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account.
This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI).
Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave.
Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.
PubMed ID
29032743 View in PubMed
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An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study.

https://arctichealth.org/en/permalink/ahliterature286745
Source
Twin Res Hum Genet. 2016 Dec;19(6):619-627
Publication Type
Article
Date
Dec-2016
Author
Lisa Mather
Victoria Blom
Gunnar Bergström
Pia Svedberg
Source
Twin Res Hum Genet. 2016 Dec;19(6):619-627
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety Disorders - epidemiology - genetics - pathology
Burnout, Professional - epidemiology - genetics - pathology
Depressive Disorder, Major - epidemiology - genetics - pathology
Diseases in Twins - epidemiology - genetics - pathology
Environment
Female
Humans
Male
Middle Aged
Risk factors
Sweden
Twins, Dizygotic - genetics
Twins, Monozygotic - genetics
Young Adult
Abstract
Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005-2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69-0.74) between MDD and GAD, 0.58 (0.56-0.60) between MDD and burnout, and 0.53 (0.50-0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.
PubMed ID
27620693 View in PubMed
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Contingent self-esteem, stressors and burnout in working women and men.

https://arctichealth.org/en/permalink/ahliterature121225
Source
Work. 2012;43(2):123-31
Publication Type
Article
Date
2012
Author
Victoria Blom
Author Affiliation
Department of Psychology, Stockholm University, SE 106 91 Stockholm, Sweden. victoria.blom@psychology.su.se
Source
Work. 2012;43(2):123-31
Date
2012
Language
English
Publication Type
Article
Keywords
Achievement
Adult
Aged
Burnout, Professional - psychology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Peer Group
Questionnaires
Regression Analysis
Self Concept
Sex Factors
Social Support
Stress, Psychological - psychology
Sweden
Task Performance and Analysis
Women, Working - psychology
Workload
Young Adult
Abstract
A high work involvement is considered central in the burnout process. Yet, research investigating how high work involvement and psychosocial stressors relate to burnout is scarce. High involvement in terms of performance-based self-esteem (PBSE) refers to individuals' strivings to validate self-worth by achievements, a disposition linked to poor health. The aim of the present study was to examine longitudinally PBSE in relation to burnout while also taking into account work- and private life stressors.
The sample consisted of 2121 working women and men.
Main- and mediation effects were investigated using hierarchical regression analysis.
The results showed performance-based self-esteem mediated partially between the stressors and burnout. Performance-based self-esteem was the strongest predictor of burnout over time, followed by private life stressors. Women experienced more work stress than did men. Men had stronger associations between work stressors and burnout, while women had stronger associations between performance-based self-esteem and burnout.
Individual characteristics along with both private life and work stressors are important predictors of burnout. Factors associated with burnout differ somewhat between women and men.
PubMed ID
22927616 View in PubMed
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The covariation between burnout and sick leave due to mental disorders is explained by a shared genetic liability: a prospective swedish twin study with a five-year follow-up.

https://arctichealth.org/en/permalink/ahliterature261078
Source
Twin Res Hum Genet. 2014 Dec;17(6):535-44
Publication Type
Article
Date
Dec-2014
Author
Lisa Mather
Gunnar Bergström
Victoria Blom
Pia Svedberg
Source
Twin Res Hum Genet. 2014 Dec;17(6):535-44
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - epidemiology - genetics
Diseases in Twins - epidemiology - genetics
Female
Follow-Up Studies
Humans
Male
Mental Disorders - epidemiology - genetics
Middle Aged
Prospective Studies
Sick Leave - statistics & numerical data
Sweden
Time Factors
Young Adult
Abstract
This study aims to assess whether the associations between burnout and sick leave due to stress-related mental disorders, other mental disorders, and somatic conditions are influenced by familial (genetic and shared environmental) factors.
In this prospective cohort study, 23,611 Swedish twins born between 1959 and 1985, who answered a web-based questionnaire, including the Pines Burnout Measure 2004-2006, were included. Registry data on sick leave spells from the response date until December 31, 2010 were obtained from the Swedish Social Insurance Agency. Logistic regression analysis was performed to assess odds ratios with 95% confidence intervals for the association between burnout and sick leave for the whole sample, while conditional logistic regression of the same-sex discordant twin pairs was used to estimate the association between burnout and sick leave, adjusting for familial confounding. The Bivariate Cholesky models were used to assess whether the covariation between burnout and sick leave was explained by common genetic and/or shared environmental factors.
Burnout was a risk factor for sick leave due to stress-related and other mental disorders, and these associations were explained by familial factors. The phenotypic correlation between burnout and sick leave due to somatic conditions was 0.07 and the association was not influenced by familial factors. The phenotypic correlations between burnout and sick leave due to stress-related (0.26) and other mental disorders (0.30) were completely explained by common genetic factors.
The association between burnout and sick leave due to stress-related and other mental disorders seems to be a reflection of a shared genetic liability.
PubMed ID
25091089 View in PubMed
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Don't let it get to you! A moderated mediated approach to the (in)justice-health relationship.

https://arctichealth.org/en/permalink/ahliterature275286
Source
J Occup Health Psychol. 2015 Oct;20(4):434-45
Publication Type
Article
Date
Oct-2015
Author
Constanze Eib
Ulrica von Thiele Schwarz
Victoria Blom
Source
J Occup Health Psychol. 2015 Oct;20(4):434-45
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Adult
Conflict (Psychology)
Family - psychology
Female
Humans
Internal-External Control
Male
Mental health
Middle Aged
Organizational Culture
Social Perception
Stress, Psychological
Surveys and Questionnaires
Sweden
Work - psychology
Workplace - psychology
Young Adult
Abstract
The present study investigates the consequences of overall justice perceptions on employees' mental health and work-family conflict. While many studies have found that perceiving injustice at work is harmful, little is known about the underlying processes. Based on the allostatic load model, it is hypothesized that mental preoccupation with work, defined as a cognitive state, is a mediator linking overall justice perceptions to employee health. Moreover, we argue that locus of control is a moderator for the mediated relationship. We tested our hypotheses with panel data consisting of 412 Swedish office workers. Results support that mental preoccupation with work mediates the relationship between overall justice and mental health, and overall justice and work-family conflict. Results also reveal that mental preoccupation with work plays a greater mediating role for individuals with an external locus of control. Implications and suggestions for future studies on the emerging relationship between organizational justice and health are discussed.
PubMed ID
25798718 View in PubMed
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Genetic and environmental influences on the association between performance-based self-esteem and exhaustion: A study of the self-worth notion of burnout.

https://arctichealth.org/en/permalink/ahliterature281364
Source
Scand J Psychol. 2016 Oct;57(5):419-26
Publication Type
Article
Date
Oct-2016
Author
Pia Svedberg
Lennart Hallsten
Jurgita Narusyte
Lennart Bodin
Victoria Blom
Source
Scand J Psychol. 2016 Oct;57(5):419-26
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - genetics - psychology
Fatigue - genetics - psychology
Female
Gene-Environment Interaction
Humans
Male
Middle Aged
Models, Psychological
Self Concept
Sweden
Work Performance
Young Adult
Abstract
In the self-worth model, burnout is considered to be a syndrome of performance-based self-esteem (PBSE) and experiences of exhaustion. Studies have shown that PBSE and burnout indices such as Pines' Burnout Measure (BM) are associated. Whether these variables have overlapping etiologies has however not been studied before. Genetic and environmental components of covariation between PBSE and exhaustion measured with Pines' BM were examined in a bivariate Cholesky model using data from 14,875 monozygotic and dizygotic Swedish twins. Fifty-two per cent of the phenotypic correlation (r = 0.41) between PBSE and Pines' BM was explained by genetics and 48% by environmental factors. The findings of the present study strengthen the assumption that PBSE should be considered in the burnout process as proposed by the self-worth conception of burnout. The present results extend our understanding of the link between this contingent self-esteem construct and exhaustion and provide additional information about the underlying mechanisms in terms of genetics and environment. This finding corroborates the assumed syndrome view on burnout, while it also suggests an altered view of how the syndrome emerges and how it can be alleviated.
PubMed ID
27452914 View in PubMed
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Genetic susceptibility to burnout in a Swedish twin cohort.

https://arctichealth.org/en/permalink/ahliterature126454
Source
Eur J Epidemiol. 2012 Mar;27(3):225-31
Publication Type
Article
Date
Mar-2012
Author
Victoria Blom
Gunnar Bergström
Lennart Hallsten
Lennart Bodin
Pia Svedberg
Author Affiliation
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Source
Eur J Epidemiol. 2012 Mar;27(3):225-31
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - genetics
Cohort Studies
Cross-Sectional Studies
Female
Gene-Environment Interaction
Health Surveys
Heredity
Humans
Male
Middle Aged
Models, Genetic
Models, Statistical
Questionnaires
Registries
Sweden
Twins, Dizygotic - genetics - psychology
Twins, Monozygotic - genetics - psychology
Abstract
Most previous studies of burnout have focused on work environmental stressors, while familial factors so far mainly have been overlooked. The aim of the study was to estimate the relative importance of genetic influences on burnout (measured with Pines Burnout Measure) in a sample of monozygotic (MZ) and dizygotic (DZ) Swedish twins. The study sample consisted of 20,286 individuals, born 1959-1986 from the Swedish twin registry who participated in the cross-sectional study of twin adults: genes and environment. Probandwise concordance rates (the risk for one twin to be affected given that his/her twin partner is affected by burnout) and within pair correlations were calculated for MZ and DZ same--and opposite sexed twin pairs. Heritability coefficients i.e. the proportion of the total variance attributable to genetic factors were calculated using standard biometrical model fitting procedures. The results showed that genetic factors explained 33% of the individual differences in burnout symptoms in women and men. Environmental factors explained a substantial part of the variation as well and are thus important to address in rehabilitation and prevention efforts to combat burnout.
Notes
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PubMed ID
22388765 View in PubMed
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High Job Demands, Job Strain, and Iso-Strain are Risk Factors for Sick Leave due to Mental Disorders: A Prospective Swedish Twin Study With a 5-Year Follow-Up.

https://arctichealth.org/en/permalink/ahliterature273568
Source
J Occup Environ Med. 2015 Aug;57(8):858-65
Publication Type
Article
Date
Aug-2015
Author
Lisa Mather
Gunnar Bergström
Victoria Blom
Pia Svedberg
Source
J Occup Environ Med. 2015 Aug;57(8):858-65
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Diseases in Twins - diagnosis - genetics - psychology
Female
Follow-Up Studies
Genetic Predisposition to Disease - genetics
Humans
Logistic Models
Male
Mental Disorders - diagnosis - genetics - psychology
Middle Aged
Occupational Diseases - diagnosis - genetics - psychology
Occupational Exposure - adverse effects
Prospective Studies
Sick Leave
Statistics as Topic
Stress, Psychological - complications - psychology
Surveys and Questionnaires
Sweden
Workload - psychology
Abstract
To investigate whether psychosocial work environment and health behaviors are risk factors for sick leave due to mental disorders, and whether familial confounding (genetics and shared environment) explains the associations.
Respondents (n = 11,729), given to complete a questionnaire in 2004 to 2006, were followed up approximately 5 years for sick leave spells due to mental disorders, using national registry data. Data were analyzed using logistic regression, and conditional logistic regression for twin pairs discordant for sick leave (cotwin control).
High job demands, job strain, and iso-strain were independent risk factors for sick leave due to mental disorders. Familial factors seem to be of importance in the associations between job support, smoking, a combination of unhealthy behaviors and sick leave.
Improving the psychosocial work environment may be effective in preventing sick leave due to mental disorders.
PubMed ID
26247639 View in PubMed
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The importance of genetic and shared environmental factors for the associations between job demands, control, support and burnout.

https://arctichealth.org/en/permalink/ahliterature106923
Source
PLoS One. 2013;8(9):e75387
Publication Type
Article
Date
2013
Author
Victoria Blom
Lennart Bodin
Gunnar Bergström
Lennart Hallsten
Pia Svedberg
Author Affiliation
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ; The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
Source
PLoS One. 2013;8(9):e75387
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Burnout, Professional - genetics
Female
Humans
Job Description
Male
Models, Theoretical
Occupational Health
Questionnaires
Risk factors
Sex Factors
Social Support
Sweden
Abstract
Within occupational health research, one of the most influential models is the Job Demands-Control-Support model. Numerous studies have applied the model to different domains, with both physical and psychological health outcomes, such as burnout. The twin design provides a unique and powerful research methodology for examining the effects of environmental risk factors on burnout while taking familial factors (genetic and shared environment) into account. The aim of the present study was to investigate the impact of familial factors on the associations of burnout with job demands, control and support. A total of 14,516 individuals from the Swedish Twin Registry, who were born between 1959 and 1986, and who participated in the Study of Twin Adults: Genes and Environment (STAGE) by responding to a web-based questionnaire in 2005, were included in the analyses. Of these, there were 5108 individuals in complete same-sex twin pairs. Co-twin control analyses were performed using linear mixed modeling, comparing between-pairs effects and within-pair effects, stratified also by zygosity and sex. The results indicate that familial factors are of importance in the association between support and burnout in both women and men, but not between job demands and burnout. There are also tendencies towards familial factors being involved in the association between control and burnout in men. These results offer increased understanding of the mechanisms involved in the associations between work stress and burnout.
Notes
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PubMed ID
24086520 View in PubMed
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Stressful and traumatic life events are associated with burnout-a cross-sectional twin study.

https://arctichealth.org/en/permalink/ahliterature263631
Source
Int J Behav Med. 2014 Dec;21(6):899-907
Publication Type
Article
Date
Dec-2014
Author
Lisa Mather
Victoria Blom
Pia Svedberg
Source
Int J Behav Med. 2014 Dec;21(6):899-907
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Cross-Sectional Studies
Female
Humans
Life Change Events
Male
Stress, Psychological - epidemiology
Sweden - epidemiology
Twins - statistics & numerical data
Young Adult
Abstract
Most burnout studies focus on symptoms of burnout in relation to work-related stress. However, recent studies have found that familial factors and stress in the personal life may also be of importance. Stressful and traumatic life events influence how individuals cope with stress over the life course and may therefore be associated with burnout symptoms.
This study aims to assess the associations between stressful and traumatic life events and burnout symptoms in a population-based sample of twins, adjusting for familial confounding.
In this cross-sectional questionnaire-based study of 25,378 Swedish twins, odds ratios (OR) with 95% confidence intervals (CI) were calculated using logistic regression analysis. First, the whole sample was analysed. Secondly, a matched co-twin analysis was conducted of the same-sex twin pairs discordant on burnout, in order to adjust for familial factors.
A history of traumatic life events was independently associated with burnout symptoms, with a cumulative effect with increasing number of events. ORs adjusted for familial confounding: 1-3 events OR 1.58 (CI?=?1.21-2.07) 4 or more events OR 2.00 (CI?=?1.45-2.75). Independent associations between the stressful life events: serious family problems OR 1.71 (CI?=?1.36-2.15), physical illness OR 1.44 (CI?=?1.17-1.77), divorce or separation OR 1.40 (CI?=?1.15-1.70), and burnout symptoms were also found.
The results indicate that stressful and traumatic life events are of importance in the burnout process. This finding may have implications in efforts to prevent burnout.
PubMed ID
24402776 View in PubMed
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11 records – page 1 of 2.