BACKGROUND: The aim of this paper is to examine the impact of depressive symptoms on long-term sickness absence in a representative sample of the Danish workforce. METHODS: This prospective study is based on 4,747 male and female employees, participating in the Danish Work Environment Cohort Study. Depressive symptoms were measured at baseline. Data on sickness absence were obtained from a national register on social transfer payments. Onset of long-term sickness absence was followed up for 78 weeks. RESULTS: The cumulative 78 weeks incidence for the onset of long-term sickness absence was 6.5% in men and 8.9% in women. Both men and women with severe depressive symptoms (