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Risk factors for further sick leave among Japanese workers returning to work after an episode of major depressive disorder: a prospective follow-up study over 1 year
  1. Hikaru Hori1,
  2. Asuka Katsuki1,
  3. Kiyokazu Atake1,
  4. Reiji Yoshimura1,
  5. Jun Nakamura2,
  6. Bernhard T Baune3,4,5
  1. 1Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
  2. 2Kitakyushu Koga Hospital, Kitakyushu, Japan
  3. 3Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
  4. 4Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
  5. 5The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Hikaru Hori; hori-h{at}


Objectives We aimed to investigate the risk factors for further sick leave episodes among Japanese workers returning to work after time off with a major depressive disorder.

Design A prospective study with 1 year of follow-up.

Participants We recruited 103 workers who had returned to work after taking sick leave with a major depressive disorder. Adjusted HRs with 95% CIs were calculated using Cox proportional hazard models to examine the risk of further sick leave.

Results In the adjusted analysis, we show that Social Adaptation Self-evaluation Scale scores (HR 0.95; p=0.019), 3-back correct response rate (N-back test) (HR 0.97; p<0.001) and benzodiazepine dosage (diazepam equivalent) (HR1.07; p=0.014) were associated with further episodes of sick leave.

Conclusions Poorer social and cognitive functioning, together with higher diazepam dosages, were associated with an increased likelihood of additional sick leave.

  • Major depressive disorder
  • cognitive function
  • social functioning
  • sick leave
  • return to work

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  • Contributors All authors contributed to and approved the final manuscript. HH and JN conceived and designed the experiments; HH, AK, JN and KA performed the experiments; HH and RY analysed the data; HH prepared the first manuscript; and RY and BTB edited the manuscript and revised the manuscript for important intellectual content.

  • Funding This work was supported by AMED under grant no. JP18dk0307060 and UOEH Research Grant for Promotion of Occupational Health.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The ethics committee of the University of Occupational and Environmental Health approved the study protocols (no. 270071).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

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