Workplace Adjustments and Sick Leave Duration Among Individuals with Stress-Related Disorders: A Longitudinal Register Follow-up in Sweden

BACKGROUND: Sick leave with stress-related disorders has increased substantially in Sweden and other OECD countries, posing a significant challenge to public health and workforce participation. whilst employer support has been shown to contribute to return to work (RTW), there is limited evidence regarding which specific workplace adjustments facilitate this process. OBJECTIVE: This study aims to investigate the types of workplace adjustments individuals with stress-related disorders receive to facilitate RTW and whether such adjustments are associated with a reduced number of sick leave days. METHODS: This study combined data from a national survey of 1,412 individuals on long-term sick leave due to stress-related disorders (ICD-10 F43 codes) with register data on sick leave from the Swedish Social Insurance Agency. Workplace adjustments were self-reported via a multiple-choice questionnaire. Sick leave outcomes were measured as gross and net sick leave days at 6 and 18 months. Multivariable quantile regression was used to examine associations between reported adjustments and the distribution of sick leave days, adjusting for age, sex, and education. RESULTS: Eighty per cent of participants reported having received at least one workplace adjustment, with changes in work tasks being most common. Quantile regression analyses revealed that workplace adjustments were associated with fewer net sick leave days, particularly among individuals with longer durations of sick leave. At 18 months, individuals who had received workplace adjustments had significantly fewer net sick leave days across the 40th to 90th percentiles, with the largest difference at the 90th percentile (153 fewer net sick leave days; p < 0.001). CONCLUSIONS: Workplace adjustments were associated with shorter durations of sick leave among individuals with stress-related disorders, particularly among those with prolonged sick leave. These findings highlight the potential relevance of individualised workplace adjustments in the rehabilitation process.