Long term sick leave, subjective health complaints and sense of coherence, a cross-sectional study

Abstract

Background: Long-term work absence is increasing in Western countries. More people suffer from subjective health complaints, such as musculoskeletal pain and depression-like symptoms. Social rights and benefits are based on medical diagnoses; hence large resources are used to identify the biological causes. An alternative approach towards medicalization and diagnosis, like Salutogenesis, with the key factor “Sense of coherence” (SOC) should be approved. Purpose: To explore the level of SOC, anxiety and depression, as well as the associations between SOC and general resistance resources (GRRs) and deficits, in people with subjective health complaints on long term sick leave. Material and methods: Cross-sectional study, including data from 892 participants from the Friskgården (Norwegian health promotion center) database. The questionnaire included the SOC-13, the Hospital Anxiety and Depression Scale and questions about demographics and sick leave. Multivariable linear regression models were used. Results: Participants’ mean (SD) age was 49 (10) years, 70% were women. Mean SOC was 59.4 (13.3). The mean anxiety and depression for all participants were 8.7 (4.4) and 6.2 (3.8) respectively. No difference was found in SOC in participants on sick leave less than, compared with more than one year (p = 0.07). Conclusions: People on long-term sick leave have lower SOC and higher level of anxiety and depression than previously shown in general populations. Large parts of the SOC variation are explained by GRRs and deficits, indicating potentials for improvement by for instance participation in Salutogenic/resource oriented therapy.