Predictors of outcome in fatigued employees on sick leave
Results from a randomised trial

J Psychosom Res, Vol 57, Issue 5, Nov 2004, Pages 443-449

Marcus J.H. Huibers [a, b, c, *], Gijs Bleijenberg [b], Ludovic G.P.M.
van Amelsvoort [a], Anna J.H.M. Beurskens [a, d], Constant P. van Schayck [c],
Ellen Bazelmans [b] and J. André Knottnerus [c]


[a] Department of Epidemiology, Maastricht University, P.O. Box 616, Maastricht
6200 MD, The Netherlands
[b] Department of Medical Psychology, UMC Nijmegen, The Netherlands
[c] Department of General Practice, Maastricht University, P.O. Box 616,
Maastricht 6200 MD, The Netherlands
[d] Department of Physiotherapy, Hogeschool Zuyd, The Netherlands
[*] Corresponding author. Department of Medical, Clinical and Experimental
Psychology, Maastricht University, P.O. Box 616, Maastricht 6200 MD, The
Netherlands. Tel.: +31 43 388 1487; fax: +31 43 388 4155 E-Mail:
m.huibers@dmkep.unimaas.nl

Received 29 April 2003;
accepted 5 March 2004.
Available online 2 December 2004.


Abstract
Objective: The main objective of this study was to identify predictors of
fatigue caseness, work resumption and chronic fatigue syndrome (CFS)-like
caseness in a sample of fatigued employees on sick leave.

Methods: For 12 months, 151 fatigued employees on sick leave, 44% of whom met
research criteria for CFS at baseline, were followed. Measures included fatigue,
health aspects, psychological problems, burnout, causal attributions and
self-efficacy. Logistic regression analysis was used to determine associations
between predictor variables at baseline and outcome at follow-up.

Results: After 12 months, 43% of the patients were no longer fatigue cases, and
62% had resumed work. Recovery from fatigue caseness was predicted by stronger
psychological attributions and other perception-related factors, whereas work
resumption was predicted by lower age, male sex, CFS-like caseness and less
cognitive difficulties. Lower physical functioning scores were predictive of
(the development of) CFS-like caseness.

Conclusion: Recovering from persistent fatigue and work resumption seem to
result from different underlying processes and do not necessarily fall together.
As many factors associated with outcome in fatigue reflect illness perception,
the prevention of persistent fatigue and CFS may partly be achieved by the
modification of perception.

Keywords: Chronic fatigue syndrome; Fatigue; Predictor analysis; Primary care;
Recovery; Sick leave


Copyright © 2004 Elsevier Inc. All rights reserved.