Association between depression screening and sick leave among employees in Serbia: Depression and sick leave in Serbia

Abstract

Objective. The mental health of employees represents a key factor affecting absenteeism and productivity. This study aimed to examine the association between depressive symptoms and absenteeism among employees in Serbia and to identify demographic and socioeconomic factors influencing this relationship.

Methods. A cross-sectional study was conducted using data from the National Health Survey, including a sample of 4,652 employees aged 18-65 years. Descriptive statistics and binary logistic regression, adjusted for demographic and socioeconomic factors, were used to analyze the association between depressive symptoms and absenteeism.

Results. The prevalence of mild depressive symptoms was 2.3%, and depressive episodes were 0.6%. Women showed significantly higher prevalence of depressive symptoms compared to men (3.9% vs 2.1%, p=0.002). The most common symptoms were fatigue (2.1%) and sleep problems (1.6%). All depressive symptoms showed a statistically significant association with absenteeism (p<0.01). Absenteeism frequency increases with symptom severity: 1.6% in the absence of symptoms, 4.7% for mild symptoms, while long-term absenteeism with mild symptoms was 10.4%. Participants with mild depressive symptoms had twice the odds for absenteeism (OR=2.01), while those with depressive episodes had over three times higher odds (OR=3.20).

Conclusion. The study confirms a significant association between the presence of depressive symptoms and absenteeism among employees in Serbia, with a clear risk gradation depending on symptom severity. Higher prevalence of depressive symptoms in women indicates the need for gender-adapted preventive approaches. Findings support the implementation of depression screening as an early strategy for reducing absenteeism in the working population.