Insecure social relations at work and long-term sickness absence due to burnout and other mental diagnoses

Objective: The association between diagnosis and psychosocial work factors in a sickness absent population was examined in order to test the existence of a previously suggested hypothesis of "the burnout staircase", a seven step process prior to the long-term sickness absence due to burnout starting with reorganisations followed by insecure social bonds affecting the work situation as well as trust in oneself and others. Participants: The study population comprised of 2055 employed sick-listed persons (1414 women, 641 men), a sub sample derived from the 2002 national Swedish survey on health, working conditions, life situation and sick-listing. Methods: Through multinomial logistic regression it was analysed if experiences of the different steps in the burnout staircase increased the probability of burnout compared to other medical diagnoses. Results: The hypothesis was supported. The study revealed strong and significant associations between having experienced reorganisations, insecure social relations fraught with conflicts, incompatible demands, lack of trust and diminished self-esteem and burnout. This was true for both women and men. Strong and significant associations were found also between each step studied and other mental diagnoses for men. Conclusion: More studies are needed to further test the hypothesis.