Workplace mental health disability leave recurs sooner than physical health leave, CAMH study shows

ScienceDaily (June 29, 2011) — The recurrence of an employee's medical leave of absence from work tends to happen much sooner with a mental health leave than a physical one, a Centre for Addiction and Mental Health (CAMH) study shows.

Most workers who take a mental health leave from their jobs do not have another disability leave for at least two years, according to a new study from CAMH. In contrast, most who have had a physical health disability leave have almost four years before a second episode.

Mental health disability leaves cost approximately $51 billion a year in Canada in health care and work disruption costs, and those with a previous episode are at higher risk of having another one.

"If we understand the timing of a repeated episode, as well as who is at risk of having a recurrence, we can develop more effective prevention programs to help people stay at work," says Dr. Carolyn Dewa, study lead and head of CAMH's Centre for Research on Employment and Workplace Health. The study was published in the June issue of the Journal of Occupational and Environmental Medicine.

For their study, Dr. Dewa and colleagues looked at the records of a Canadian company with 13,000 employees from 2003 to 2006. Among this group, 3,593 employees had one or more disability leaves during this period. An episode was at least five continuous days off work related to a medical diagnosis.

Among all workers, 72 per cent who had a disability leave were still at work after a year. Those who were more likely to have a second episode sooner included women, maintenance workers and those with disrupted marriages.

"It's important to be aware that although workers who have had one mental health disability leave are at risk of having a recurrence, it doesn't happen immediately," added Dr. Dewa. "These workers want to be back at work, but unfortunately, sometimes supports to help maintain their health are not available." It is important to do return-to-work planning to help employees transition back after a leave. Workplace resources can be very valuable in sustaining worker well-being and help them remain on the job longer.

It is a complex task to untangle the reasons why mental health disability leave recurs sooner than those for physical health. It is possible the workers in the study had not fully recovered when they returned, because some aspects of their illness were overlooked, the researchers point out.

"The workers' major symptoms may have subsided, but their ability to work may still be impaired due to memory loss or inability to focus," says Dr. Dewa. "The return-to-work forms that physicians fill out don't always ask about a person's functional abilities at work, just about medical symptoms. And workers may attribute symptoms such as memory loss or lack of focus to aging."

If a workers' ability to do their job is impaired, it could create resentment among their colleagues -- and there is growing evidence to suggest social support, both within and outside the workplace, is important to prevent psychiatric disorders. This may explain, for example, why those with disrupted marriages relapsed sooner. Past research also shows a link between low social support and depression in women.

Finding the right balance of providing social support without intruding too much or violating a person's privacy is challenging, but possible, says Dr. Dewa. "Occupational health staff can provide support or just check in with workers who have had a previous disability leave. People like it when you genuinely care about the answer to, 'How are you?'"

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Centre for Addiction and Mental Health, via EurekAlert!, a service of AAAS.

Note: If no author is given, the source is cited instead.

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People at risk for panic buffered from stressor by high levels of physical activity

ScienceDaily (July 14, 2011) — Regular exercise may be a useful strategy for helping prevent the development of panic and related disorders, a new study suggests.

People with an intense fear of the nausea, racing heart, dizziness, stomachaches and shortness of breath that accompany panic -- known as "high anxiety sensitivity" -- reacted with less anxiety to a panic-inducing stressor if they had been engaging in high levels of physical activity, said researchers at Southern Methodist University in Dallas and the University of Vermont in Burlington.

"Anxiety sensitivity is an established risk factor for the development of panic and related disorders," said SMU psychologist Jasper Smits, lead author on the research. "This study suggests that this risk factor may be less influential among persons who routinely engage in high levels of physical activity."

Regular exercise as an alternative or complementary strategy to drugs and psychotherapy

There is already good evidence that exercise can be of help to people who suffer from depression and anxiety problems, say the researchers.

"We're not suggesting, 'Exercise instead of pharmacotherapy or psychotherapy,'" Smits said. "Exercise is a useful alternative, particularly for those without access to traditional treatments. Primary care physicians already prescribe exercise for general health, so exercise may have the advantage of helping reach more people in need of treatment for depression and anxiety."

Smits reported the findings in "The Interplay Between Physical Activity and Anxiety Sensitivity in Fearful Responding to Carbon Dioxide Challenge," an article that has published online and is in press with the scientific journal Psychosomatic Medicine.

Co-authors include SMU psychology researchers Candyce Tart and David Rosenfield, and University of Vermont psychologist Michael Zvolensky.

New study adds to earlier research finding exercise reduces anxiety

The study builds on findings of earlier research, outlined in "Exercise for Mood and Anxiety: Proven strategies for overcoming depression and enhancing well-being" (Oxford University Press, 2011) by psychologists Michael Otto and Jasper Smits. That research indicates exercise improves mood and reduces anxiety, working like "an antidepressant drug."

Also, a 2008 study by Smits, director of the SMU Anxiety Research & Treatment Program and associate professor in the SMU Psychology Department, and Otto, a professor in Boston University's Psychology Department, indicated that exercise can also reduce anxiety sensitivity. That research, combined with the new findings, indicates that exercise may be an effective strategy for the prevention and treatment of anxiety disorders.

"Exercise can be a powerful addition to the range of treatments for depression, anxiety and general stress," said Otto. "And when people exercise to feel good, they are also taking the exact steps they need to benefit their general health."

Those with high anxiety sensitivity have greater risk of an attack

Anxiety sensitivity is the extent to which individuals fear they will be harmed by anxiety-related bodily sensations such as a racing heart, dizziness and shortness of breath, say the authors.

Research shows that the higher a person's anxiety sensitivity, the greater their risk for developing panic attacks and related psychological disorders.

"For people who have high anxiety sensitivity, the symptoms of anxiety tend to signal threat," said Smits. "They worry, 'I'll have a panic attack,' 'I'll die,' 'I'll go crazy,' 'I'll lose control' or 'I'll make a fool of myself.' That's been widely studied as one of the risk factors for development of anxiety disorders, mostly panic. And it's a robust risk factor in that it's been replicated in several studies."

Physical activity + fear of panic sensations = less reactivity to panic-relevant stressor

For the latest study, the researchers measured anxiety reactivity to a panic-related stressor, namely the inhalation of carbon dioxide-enriched air.

Study participants were 145 adult volunteers who had no history of panic attacks. After completing questionnaires measuring their physical activity and anxiety sensitivity, the participants inhaled a mixture of room air enriched with carbon dioxide, a benign procedure that typically induces a number of bodily sensations, including nausea, racing heart, dizziness, stomachaches and shortness of breath.

After inhalation, participants indicated their level of anxiety in reaction to the sensations.

The results showed that anxiety reactivity to the stressor was dampened among individuals who have been regularly engaging in high levels of physical activity.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Southern Methodist University.

Journal Reference:

Jasper A.J. Smits, Candyce D. Tart, David Rosenfield and Michael J. Zvolensky. The Interplay Between Physical Activity and Anxiety Sensitivity in Fearful Responding to Carbon Dioxide Challenge. Psychosomatic Medicine, July 2011 vol. 73 no. 6 498-503 DOI: 10.1097/%u200BPSY.0b013e3182223b28

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here