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In't Hout L, van Hees SGM, Vossen E, Oomens S, van de Mheen D, Blonk RWB. Factors Related to the Recurrence of Sickness Absence Due to Common Mental Health Disorders: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10224-9. [PMID: 38985239 DOI: 10.1007/s10926-024-10224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE Employees who experience sickness absence (SA) due to common mental disorders (CMD) are at increased risk of recurrent sickness absence (RSA). This systematic literature review examines the factors at different levels in the work and non-work context that increase or decrease the likelihood of RSA due to CMD. The resulting knowledge enables more accurate identification of employees at risk of RSA. METHODS We conducted a search in June 2023 using the following databases: PubMed, PsycInfo, Web of Science, Cumulative Index to Nursing & Allied Health Literature (Cinahl), Embase and Business Source Ultimate (BSU). Inclusion criteria were as follows: (self-)employees, CMD, related factors, RSA. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Individual, Group, Leader, Organisation and Overarching/social context (IGLOO) model were used to cluster the found factors and these factors were graded by evidence grading. RESULTS Nineteen quantitative and one qualitative studies of mainly high and some moderate quality were included in this review. A total of 78 factors were found. These factors were grouped according to the IGLOO levels and merged in 17 key factors. After evidence grading, we found that mainly low socioeconomic status (SES) and the type of previous SA (short-term SA and SA due to CMD) are predictors of an increased risk of RSA. CONCLUSIONS Having a low SES and previous experience of SA (short term, or due to CMD) are factors that predict the chance of RSA, implying the need for prolonged support from occupational health professionals after the employee has returned to work.
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Affiliation(s)
- Lydia In't Hout
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | - Suzanne G M van Hees
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Emma Vossen
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Shirley Oomens
- Occupational and Health Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboudumc, Nijmegen School of Occupational Health, Nijmegen, The Netherlands
| | - Dike van de Mheen
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Roland W B Blonk
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Science, Tilburg University, Tilburg, The Netherlands
- Optentia, North-West University, Vanderbijlpark, South Africa
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Chen YH, Saffari M, Lin CY, Tang HM, Yang CW, Lee CH, Wang WY, Jong GP. Burnout during the COVID-19 pandemic among nurses in Taiwan: the parental role effect on burnout. BMC Health Serv Res 2024; 24:703. [PMID: 38835036 PMCID: PMC11151642 DOI: 10.1186/s12913-024-11159-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/31/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, medical workers were concerned about the care of their children or family members and the impact of being separated from them. This increased stress could harm the relationship between nurses and patients. This study assessed how medical workers' parental role may affect burnout during such a high-stress period. METHODS This cross-sectional observational study was carried out in 2021 during the COVID-19 pandemic. The client burnout (CB) scale of the Copenhagen Burnout Inventory, the Nordic Musculoskeletal Questionnaire, and a demographic questionnaire were used. Statistical methods such as the t-test, one-way ANOVA, and univariable/multiple linear regression were applied. RESULTS A total of 612 nurses were included in this study. The likely risk factors of CB were identified and the parenthood effect was found to be associated with reduced CB. The parental role and leisure activity with family and friends on CB were found to have an impact. Engaging in leisure activity with family and playing the role of a parent diligently will help relieve nurses' burnout from frequent contact with patients and their families, thus lowering the risk of clinical burnout. CONCLUSION The parental role, family/friends relationships, and a complex work environment associated with nurses' burnout during the COVID-19 pandemic. This finding allows us to re-examine the importance of family life and parent-child relationships in high-stress work environments.
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Affiliation(s)
- Yong-Hsin Chen
- Department of Public Health, Chung Shan Medical University, Taichung, 402, Taiwan
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan , Taiwan
| | - Hsiu-Mei Tang
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Ching-Wen Yang
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Chiu-Hsian Lee
- Department of Nursing, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South Dist, Taichung, 402306, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist, Taichung, 402306, Taiwan
| | - Wei-Yao Wang
- Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist, Taichung, 402306, Taiwan, ROC.
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
| | - Gwo-Ping Jong
- Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist, Taichung, 402306, Taiwan, ROC.
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
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van de Leur JC, Jovicic F, Åhslund A, McCracken LM, Buhrman M. Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. Int J Behav Med 2024; 31:175-191. [PMID: 37308772 PMCID: PMC11001660 DOI: 10.1007/s12529-023-10185-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exhaustion due to persistent non-traumatic stress (ENTS) is a significant health problem with substantial personal, social, and economic impact. While there are increasing studies of ENTS, there is no international agreement on how it should be diagnosed and treated. This scoping review aimed to map definitions, diagnoses, treatments, outcome measures, and outcomes in psychological treatment studies of ENTS. A further aim was to assess the quality of the treatments and map what change processes are described within ENTS interventions. METHODS A PRISMA-guided scoping review of psychological treatment studies delivered in a clinical setting for ENTS was conducted using the databases of PubMed, PsycINFO, and CINAHL. RESULTS Of the 60 studies included, the majority (87%) stemmed from Europe. The most recurrent term for ENTS was burnout, and the diagnosis most often utilized was exhaustion disorder. Several treatments were reported, the most frequent being cognitive behavioral therapy (CBT) (68%). Statistically significant outcomes relevant to ENTS were reported in 65% (n = 39) of the studies, with effect sizes between 0.13 and 1.80. In addition, 28% of the treatments were rated as high quality. The most frequent change processes described were dysfunctional sleep, avoidance, behavioral activation, irrational thoughts and beliefs, worry, perceived competence/positive management, psychological flexibility, and recuperation. CONCLUSIONS While several treatments based on CBT show promising results for ENTS, there do not seem to be any uniformly established methods, theoretical models, or change processes. Instead of adopting a monocausal, syndromal, and potentially bio-reductionist perspective on ENTS, a process-based approach to treatment is encouraged.
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Affiliation(s)
- Jakob Clason van de Leur
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden.
- PBM Globen Rehab, Arenavägen 27, 121 77, Johanneshov, Sweden.
| | - Filip Jovicic
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Andreas Åhslund
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Lance M McCracken
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
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Xu H, Cai J, Sawhney R, Jiang S, Buys N, Sun J. The Effectiveness of Cognitive-Behavioral Therapy in Helping People on Sick Leave to Return to Work: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:4-36. [PMID: 37067701 PMCID: PMC10899273 DOI: 10.1007/s10926-023-10116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work. METHODS Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function). RESULTS Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction - 3.654; 95%CI - 5.253, - 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability. CONCLUSIONS The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.
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Affiliation(s)
- Huaying Xu
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Jinxuan Cai
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Rakshat Sawhney
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Stephen Jiang
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Nicholas Buys
- Centre for Work, Organisation and Wellbing, Griffith University, Nathan, Q4215, Australia
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia.
- Institute for Integrated Intelligence and Systems, Griffith University, Nathan, Q4215, Australia.
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Lecours A, Coutu MF, Durand MJ. Fostering Stay at Work After a Period of Disability: A Scoping Review of Occupational Rehabilitation Strategies to Support Workers in the Adoption of Preventive Behaviours. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:56-70. [PMID: 37358726 DOI: 10.1007/s10926-023-10122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. METHODS To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. RESULTS We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. CONCLUSION The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.
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Affiliation(s)
- Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, 555 Boul de l'Université, Drummondville, Québec, J2C 0R5, Canada.
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec, Canada.
| | - Marie-France Coutu
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
| | - Marie-José Durand
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
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Gray NS, Davies H, Brad R, Snowden RJ. Reducing sickness absence and stigma due to mental health difficulties: a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail). BMC Public Health 2023; 23:1324. [PMID: 37430234 DOI: 10.1186/s12889-023-16200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/27/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Common mental disorders are the leading cause of workplace absences. The Prevail intervention programme aims to reduce stigma and to educate staff and managers about evidence-based low intensity psychological interventions for common mental disorders (depression, anxiety, stress, and distress). Prevail is innovative in taking a public health approach. It is designed to be given to all employees irrespective of their past or current mental health. Prevail was evaluated in three studies examining: (1) the acceptability of the intervention and perceived usefulness; (2) whether the intervention altered stigmatic attitudes and motivation to seek help; and (3) whether the intervention reduced sickness absence, both overall and due to mental health problems. METHODS A two-armed cluster randomised control trial (RCT) evaluated the effectiveness of Prevail. Employees (N = 1051) at a large UK government institution were randomised to an active intervention or control arm in teams identified by their managers (n = 67). Employees in the active arm received the Prevail Staff Intervention. The managers in the active arm also received the Prevail Managers Intervention. Participants' satisfaction and analysis of the Prevail Intervention were gathered by a bespoke questionnaire. Questionnaire measures of attitudes to mental health and mental health stigma were taken 1-2 weeks prior to the intervention and approximately 4 weeks post-intervention. Data relating to sickness absence were gathered via the official records in the time period 3-month post-intervention and for the same period 12 months earlier. RESULTS Prevail was evaluated highly favourably by both the staff and their managers. Prevail produced significant reductions in self-stigma and anticipated stigma due to mental health difficulties. Crucially, sickness absence was significantly reduced by the Prevail Intervention. DISCUSSION Prevail achieved its goals of producing a palatable and engaging intervention that altered staff's attitudes and stigmatic beliefs related to mental health and, crucially, produced a strong reduction in work-pace absenteeism. As the Prevail programme is aimed at common mental health problems and was not specialised to this particular workforce, the study provides the evidence-base for a mental health intervention programme that could be used by many organisations across the world. TRIAL REGISTRATION ISRCTN12040087. Registered 04/05/2020. https://doi.org/10.1186/ISRCTN12040087 . A full protocol for the randomised control trial was published: Gray NS, Davies H, Snowden RJ: Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail). BMC Public Health 2020, 20(1):1-9.
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Affiliation(s)
- Nicola S Gray
- Department of Psychology, Swansea University, Swansea, Wales, SA2 8PP, UK.
- Caswell Clinic, Swansea Bay University Health Board, Bridgend, UK.
| | - Helen Davies
- Driver and Vehicle Licensing Agency (DVLA), Swansea, UK
| | - Rhodri Brad
- Driver and Vehicle Licensing Agency (DVLA), Swansea, UK
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Slater D, Venning A, Matthews L, Iles R, Redpath P. Defining work-focused cognitive behavioural therapy (W-CBT) and whether it is effective at facilitating return to work for people experiencing mental health conditions: A systematic review and narrative synthesis. Health Psychol Open 2023; 10:20551029231217840. [PMID: 38028506 PMCID: PMC10676636 DOI: 10.1177/20551029231217840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
It is unclear what constitutes Work Focused Cognitive Behaviour Therapy (W-CBT). This review sought to define W-CBT and ascertain its effectiveness at facilitating return to work (RTW) for people experiencing mental health conditions. A systematic review and narrative synthesis were undertaken. Five databases were searched (Medline, ProQuest, PsychInfo, Scopus, and Web of Science). English publications with an intervention combining CBT with RTW were selected. Quality checklists from the Joanna Briggs Institute were applied. Searching yielded 16,863 results. 23 moderate-to-high quality studies from 25 articles were included (13 experimentally designed studies, 3 pilots/case studies and 7 reviews). Results indicated W-CBT is effective at facilitating RTW for mild-to-moderate mental health conditions. For a program to be labelled W-CBT it is recommended it is (1) a stand-alone intervention; (2) delivered with an understanding RTW is the goal; and, (3) the CBT components are always framed by matters, subjects and contexts related to work.
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Affiliation(s)
- Dylan Slater
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| | - Anthony Venning
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| | - Lynda Matthews
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ross Iles
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Paula Redpath
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
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Morgan MA, Kelber MS, Bellanti DM, Beech EH, Boyd C, Galloway L, Ojha S, Garvey Wilson AL, Otto J, Belsher BE. Outcomes and prognosis of adjustment disorder in adults: A systematic review. J Psychiatr Res 2022; 156:498-510. [PMID: 36347110 DOI: 10.1016/j.jpsychires.2022.10.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Adjustment disorder (AD) is one of the most commonly diagnosed mental health disorders and is generally conceptualized to be mild and short-lived. Despite the frequent use of AD in clinical settings, little is known about the prognosis of this condition. Our goal was to systematically review research on a range of AD outcomes in order to provide a broad characterization of AD prognosis. We conducted searches in MEDLINE, EMBASE, and PsycINFO. We included 31 cohort or randomized controlled trials with a total of 1,385,358 participants. Many patients maintained an AD diagnosis or were diagnosed with another mental health disorder months to years after initial diagnosis. Patients with AD tended to show symptom improvement at higher rates and to utilize less treatment than did patients with other disorders. AD-diagnosed groups experienced subsequent development of numerous physical conditions, such as infection, cancers, Parkinson's disease, and cardiovascular events, at higher rates than did control groups. Results were mixed regarding suicidality and occupational impairment. We rated most studies as having a moderate risk of bias. Based on limited findings, AD appears to progress as a milder disorder than do other disorders, but it not uncommonly transitions to more severe mental health states and may predict the development of future health issues, both mental and physical. Future prospective research that conforms to prognosis study guidelines is needed to better understand the course of this common disorder.
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Affiliation(s)
- Maria A Morgan
- Psychological Health Center of Excellence, Defense Health Agency, USA.
| | | | - Dawn M Bellanti
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Erin H Beech
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Courtney Boyd
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Lindsay Galloway
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Suman Ojha
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Abigail L Garvey Wilson
- Psychological Health Center of Excellence, Defense Health Agency, USA; Department of Epidemiology, George Washington University, Washington, DC, USA
| | - Jean Otto
- Psychological Health Center of Excellence, Defense Health Agency, USA
| | - Bradley E Belsher
- Psychological Health Center of Excellence, Defense Health Agency, USA; Phoenix VA Health Care System, Carl T. Hayden Veterans Medical Center, Phoenix, AZ, USA
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Chen YH, Lou SZ, Yang CW, Tang HM, Lee CH, Jong GP. Effect of Marriage on Burnout among Healthcare Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315811. [PMID: 36497885 PMCID: PMC9737389 DOI: 10.3390/ijerph192315811] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 06/12/2023]
Abstract
Since the onset of the COVID-19 pandemic, burnout symptoms have been prevalent among healthcare workers. Living with spouses can be complex and was associated with an increased burnout risk during the COVID-19 pandemic. This study investigated the relationship between living with spouses and burnout among healthcare workers during the COVID-19 pandemic. We distributed questionnaires to participants working in a hospital affiliated with a medical university in Taiwan. The questionnaires were the Copenhagen Burnout Inventory, which comprises personal burnout (PB), work-related burnout (WB), and client burnout subscales; the Nordic Musculoskeletal Questionnaire; and information on basic demographic variables, family factors, living habits, work-related factors, and physical health factors. Multiple linear regression and mediation analysis were used. We obtained 1615 (63.81%) valid questionnaires. After analysis revealed that marriage was an independent risk factor for PB; however, the effect of marriage on WB was nonsignificant after controlling for risk factors. Parenthood, less alcohol use, reported sleep duration less than six hours, less overtime, less shift work, and participation in leisure activities with family and friends were found to be mediators between marriage and a lower WB level. In addition, chronic diseases, frequent neck pain, and shoulder pain were suppression factors. In summary, marriage was associated with an increased risk of PB. Married individuals sustain a high WB level because of changes in family roles, living conditions, and work conditions. Overall, helping healthcare workers to maintain well-being in marriage or family living may be effective in decreasing burnout during the COVID-19 pandemic.
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Affiliation(s)
- Yong-Hsin Chen
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shu-Zon Lou
- Department of Occupational Therapy, Chung Shan Medical University, Taichung 40201, Taiwan
- Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Ching-wen Yang
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Hsiu-Mei Tang
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Chiu-Hsiang Lee
- Department of Nursing, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Gwo-Ping Jong
- Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung 40201, Taiwan
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Moe-Byrne T, Shepherd J, Merecz-Kot D, Sinokki M, Naumanen P, Hakkaart-van Roijen L, Van Der Feltz-Cornelis C. Effectiveness of tailored digital health interventions for mental health at the workplace: A systematic review of randomised controlled trials. PLOS DIGITAL HEALTH 2022; 1:e0000123. [PMID: 36812547 PMCID: PMC9931277 DOI: 10.1371/journal.pdig.0000123] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/09/2022] [Indexed: 06/08/2023]
Abstract
Mental health problems in the workplace are common and have a considerable impact on employee wellbeing and productivity. Mental ill-health costs employers between £33 billion and £42 billion a year. According to a 2020 HSE report, roughly 2,440 per 100,000 workers in the UK were affected by work-related stress, depression, or anxiety, resulting in an estimated 17.9 million working days lost. We performed a systematic review of randomised controlled trials (RCTs) to assess the effect of tailored digital health interventions provided in the workplace aiming to improve mental health, presenteeism and absenteeism of employees. We searched several databases for RCTs published from 2000 onwards. Data were extracted into a standardised data extraction form. The quality of the included studies was assessed using the Cochrane Risk of Bias tool. Due to the heterogeneity of outcome measures, narrative synthesis was used to summarise the findings. Seven RCTs (eight publications) were included that evaluated tailored digital interventions versus waiting list control or usual care to improve physical and mental health outcomes and work productivity. The results are promising to the advantage of tailored digital interventions regarding presenteeism, sleep, stress levels, and physical symptoms related to somatisation; but less for addressing depression, anxiety, and absenteeism. Even though tailored digital interventions did not reduce anxiety and depression in the general working population, they significantly reduced depression and anxiety in employees with higher levels of psychological distress. Tailored digital interventions seem more effective in employees with higher levels of distress, presenteeism or absenteeism than in the general working population. There was high heterogeneity in outcome measures, especially for work productivity; this should be a focus of attention in future studies.
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Affiliation(s)
| | - Jessie Shepherd
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Marjo Sinokki
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Päivi Naumanen
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Christina Van Der Feltz-Cornelis
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
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Alcohol Use among Swedish Patients with Stress-Induced Exhaustion Disorder, and Its Relation to Anxiety, Depression, and Health-Related Quality of Life. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AbstractHarmful drinking may be a cause and an effect of psychological distress, and compromises the effects of treatment for psychiatric conditions. There is a paucity of studies investigating patterns of alcohol consumption among patients with stress-induced exhaustion disorder (SED). The aims of this investigation were (1) to assess the prevalence of self-rated hazardous drinking in a sample of 808 Swedish patients with SED (mean age 43 ± 9 years, 84% women), and (2) to investigate differences in sociodemographic variables, psychological symptoms, health-related quality of life, and sleep variables between patients with different drinking patterns The design was cross-sectional and data were collected with questionnaires at pre-treatment. Twelve percent of female and 13% of male patients reported Alcohol Use Disorder Identification Test (AUDIT) scores indicating hazardous drinking. Female patients with hazardous drinking reported higher levels of anxiety and depression and lower mental wellbeing, than other women. Female patients reporting no drinking reported poorer physical function and more pain, than other women. No differences were seen between male patients with different drinking patterns. Although patients with SED report a lower frequency of harmful drinking than other psychiatric samples, alcohol consumption needs to be addressed in the assessment and treatment of this condition.
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12
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Hong JP, Lee CH, Lee YH, Escorpizo R, Chiang YC, Liou TH. Functional status and return to work in people with major depression: a 3-year national follow-up study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1179-1188. [PMID: 35150307 DOI: 10.1007/s00127-022-02240-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/22/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Major depressive disorder (MDD) affects a person's function of daily activities, including work participation. Such functional impairments often persist even when other symptoms of MDD are remitted. Increasing evidence highlights the health-promoting effects of returning to work (RTW) in various diseases. However, limited data are available regarding the impact of return to work on functional recovery in MDD. We explored the association between RTW and functional improvements in people with MDD using a large nationally representative database and a 3-year follow-up. METHODS Data of people with an MDD diagnosis were selected from the Taiwan Data Bank of Persons with disability for the period between July 11, 2012, and October 31, 2018. We included 4038 adults aged 18-64 years. The World Health Organization Disability Assessment Schedule 2.0 was used for functional assessment. The association between RTW and functional improvements was investigated using a multivariable regression analysis adjusted for confounding variables. RESULTS Women aged ≥ 45 years with a lower education level were vulnerable to prolonged unemployment. RTW was significantly associated with better functional improvements in cognition, mobility, self-care, getting along, life activity, and participation than unemployment. CONCLUSIONS RTW was positively associated with functional improvements in patients with MDD. A referral system targeting re-employment may be suggested during MDD treatment, especially for individuals at risk of prolonged unemployment.
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Affiliation(s)
- Jia-Pei Hong
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, No. 291 Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan
| | - Chih-Hong Lee
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and Department of Neurology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, No. 291 Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Yu-Chen Chiang
- Department of Psychiatry, Taipei Medical University Shuang Ho Hospital, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, No. 291 Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan. .,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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13
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Cederberg M, Alsén S, Ali L, Ekman I, Glise K, Jonsdottir IH, Gyllensten H, Swedberg K, Fors A. Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial. JMIR Ment Health 2022; 9:e30966. [PMID: 35289756 PMCID: PMC8965681 DOI: 10.2196/30966] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. OBJECTIVE The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. METHODS A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. RESULTS At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. CONCLUSIONS A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave. TRIAL REGISTRATION ClinicalTrials.gov NCT03404583; https://clinicaltrials.gov/ct2/show/NCT03404583.
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Affiliation(s)
- Matilda Cederberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Alsén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Östra, Gothenburg, Sweden
| | - Kristina Glise
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karl Swedberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Östra, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Research and Development, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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14
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Persson Asplund R, Asplund S, von Buxhoeveden H, Delby H, Eriksson K, Svenning Gerhardsson M, Palm J, Skyttberg T, Torstensson J, Ljótsson B, Carlbring P, Andersson G. Work-focused versus generic internet-based interventions for employees with stress-related disorders: A randomized controlled trial (Preprint). J Med Internet Res 2022; 25:e34446. [PMID: 37097739 PMCID: PMC10170369 DOI: 10.2196/34446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/22/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In recent decades, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. The internet provides new options for broad dissemination, and a growing body of evidence suggests that web-based interventions for stress might be effective. However, few studies have examined the efficacy of interventions in clinical samples and work-related outcomes. OBJECTIVE The aim of this study was to evaluate the efficacy of an internet-based cognitive behavioral intervention for stress-related disorders integrating work-related aspects (work-focused and internet-based cognitive behavioral therapy [W-iCBT]), compared with a generic internet-based cognitive behavioral therapy (iCBT) group and a waitlist control (WLC) group. METHODS In this trial, 182 employees, mainly employed in the health care, IT, or educational sector, who fulfilled the criteria for a stress-related disorder, were randomized to a 10-week W-iCBT (n=61, 33.5%), generic iCBT (n=61, 33.5%), or WLC (n=60, 33%). Self-rated questionnaires on perceived stress, burnout, exhaustion, and other mental health- and work-related outcomes were administered before and after the treatment and at 6- and 12-month follow-ups. RESULTS Compared with the WLC group, participants of the W-iCBT and iCBT groups showed an equal and significant reduction in the primary outcome (Shirom-Melamed Burnout Questionnaire [SMBQ]) from pretreatment to posttreatment assessment (Cohen d=1.00 and 0.83, respectively) and at the 6-month follow-up (Cohen d=0.74 and 0.74, respectively). Significant moderate-to-large effect sizes were also found in the secondary health- and work-related outcomes. The W-iCBT was the only group that exhibited significant effects on work ability and short-term sickness absence. Short-term sickness absence was 445 days lower than the WLC group and 324 days lower than the iCBT intervention group. However, no significant differences were found in terms of work experience or long-term sick leave. CONCLUSIONS The work-focused and generic iCBT interventions proved to be superior compared with the control condition in reducing chronic stress and several other mental health-related symptoms. Interestingly, effects on work ability and short-term sickness absence were only seen between the W-iCBT intervention and the WLC groups. These preliminary results are promising, indicating that treatments that include work aspects may have the potential to accelerate recovery and reduce short-term sickness absence because of stress-related disorders. TRIAL REGISTRATION ClinicalTrials.gov NCT05240495; https://clinicaltrials.gov/ct2/show/NCT05240495 (retrospectively registered).
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Affiliation(s)
- Robert Persson Asplund
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Sofia Asplund
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Helene von Buxhoeveden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Hanna Delby
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Karin Eriksson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | | | - Joachim Palm
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Thea Skyttberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Julia Torstensson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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15
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Okamoto Y, Takanashi R, Sutoh C, Domon Y, Yamada M, Baba Y, Aya C, Yamanouchi N, Sasaki H, Shimizu E. Improvement in social anxiety following a return-to-work intervention for patients with depression. Medicine (Baltimore) 2022; 101:e28845. [PMID: 35363180 PMCID: PMC9282077 DOI: 10.1097/md.0000000000028845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/28/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To retrospectively examine depression and social anxiety improvement in patients on sick leave due to depression who participated in a return-to-work intervention (RTW-I) program. METHODS Patients visited a psychiatric outpatient clinic simulating workplaces to learn recurrence prevention skills through RTW-Is, including group cognitive behavioral therapy, from April 1, 2013, to September 30, 2017. The Beck Depression Inventory-Second Edition (BDI-II), Social Adaptation Self-Evaluation Scale (SASS), and Liebowitz Social Anxiety Scale (LSAS) scores of 112 patients were analyzed before and after the intervention program. Missing postprogram data were substituted using the last observation carried forward scores. Next, 45 patients who responded to the work continuity survey 1 year after RTW-I were categorized into Group A (patients who continued working: 37) and Group B (those who did not continue: 8). RESULTS The mean BDI-II scores significantly decreased from preintervention 19.4 to postintervention 7.9 (t = 13.303, P < .001). The mean SASS scores significantly increased from preintervention 31.9 to postintervention 36.0 (t = -5.953, P < .001). The mean LSAS scores significantly decreased from preintervention 54.7 to postintervention 37.0 (t = 8.682, P < .001), and all scores demonstrated an improvement. Patients who continued working showed improved depressive and social anxiety symptoms. The BDI-II and SASS scores showed no significant differences between the groups, but the postintervention LSAS scores were significantly different (P = .041). LSAS score changes: Group A = -26.2; Group B = -9.8; estimated difference: -17.920, 95% CI: -32.181 to -3.659, P = .015. CONCLUSIONS The RTW-I program improved depressive and social anxiety symptoms. Patients with improved scores continued working for 1 year after the intervention.Trial registration: This trial was retrospectively registered with the UMIN Clinical Trial Registry (UMIN-CTR) (ID: UMIN000037662) on August 10, 2019.
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Affiliation(s)
- Yoko Okamoto
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
- Research Center for Child Mental Development, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
| | - Rieko Takanashi
- Research Center for Child Mental Development, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
- Department of Psychology, Faculty of Liberal Arts Teikyo University, 359 Otsuka, Hachioji, Tokyo, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
| | - Yuki Domon
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Mayuko Yamada
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Yoko Baba
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Chiaki Aya
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Naoto Yamanouchi
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Hajime Sasaki
- Kokorono Kaze Chiba Clinic, Tsukamoto Chiba Third Building 9F, 2-5-15 Fujimi, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
- Research Center for Child Mental Development, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
- Cognitive Behavioral Therapy Center, Chiba University Hospital, 1-8-1, Inohana, Chuou-ku, Chiba-shi, Chiba, Japan
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16
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van Dam A. A clinical perspective on burnout: diagnosis, classification, and treatment of clinical burnout. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2021. [DOI: 10.1080/1359432x.2021.1948400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Arno van Dam
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department Research and Innovation, GGZ WNB Mental Health Institute, Research and Innovation, Halsteren, The Netherlands
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17
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Hoaki Y, Terao T. Frequency of Participation in a Return-to-Work Program Predicts Successful Work Restoration but Not Maintenance. Front Psychiatry 2021; 12:620520. [PMID: 34054592 PMCID: PMC8160237 DOI: 10.3389/fpsyt.2021.620520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Several predictors for work restoration and maintenance of restoration have been examined among employees with mood and/or anxiety disorders, but whether frequency of participation in a return-to-work (RTW) program can predict successful work restoration and maintenance remains unclear. In the present study, we attempted to investigate the hypothesis that the frequency of RTW program participation can predict successful work restoration and maintenance. Among seventy-seven patients attending an RTW program, the frequency of participation was positively associated with work restoration but not with maintenance. The result was in partial agreement (restoration) and partial disagreement (maintenance of restoration) with our hypothesis. Thus, the present study suggests that the frequency of participation in an RTW program can predict successful work restoration but not maintenance.
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Affiliation(s)
- Yuriko Hoaki
- Department of Psychiatry, Oita Okanoue Hospital, Oita, Japan
| | - Takeshi Terao
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan
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18
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Abstract
BACKGROUND Adjustment disorder requires therapeutic intervention because of its complications, which include a significant risk of suicide, but evidence-based therapeutic guidelines are not available. AREAS OF UNCERTAINTY The main problem is related to answer to the following question: What is the optimal therapeutic approach to adjustment disorder? In this respect we review all randomized controlled trials that aimed to investigate therapeutic interventions for adjustment disorder in adult populations. DATA SOURCES Comprehensive search of the electronic database PubMed (January 1980-June 2019). The review included clinical trials that aimed to investigate a psychological or pharmacological treatment for adjustment disorder in adult population and reported outcome data for therapeutic interventions. RESULTS The search identified 23 studies that fulfilled the inclusion criteria for this review. Pharmacotherapy interventions were the focus of 11 studies that used various medications and dosages including viloxazine, lormetazepam, S-adenosylmethionine, pivagabine, trazodone, clorazepate, etifoxine, lorazepam, diazepam, afobazole, and plant extracts (Kava-kava, Euphytose, and Ginkgo biloba) on a total number of 1020 patients. Psychotherapy interventions were identified in 12 studies that used mirror therapy, short-term dynamic psychotherapy, yoga meditation, body-mind-spirit technique, mindfulness, bibliotherapy (self-help manual), humor training, and cognitive behavioral therapy. CONCLUSIONS Psychotherapy seems indicated for mildly symptomatic adjustment disorder. Given the fact that adjustment disorder with severe symptoms is associated with a high risk of suicidal ideation and suicide attempts, clinicians must consider the potential benefit of using psychotropic agents such as benzodiazepines, antidepressants, or etifoxine.
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19
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Audhoe SS, Hoving JL, Zijlstra BJH, Frings-Dresen MHW, Nieuwenhuijsen K. Is the "Brainwork Intervention" effective in reducing sick leave for non-permanent workers with psychological problems? Results of a controlled clinical trial. BMC Public Health 2021; 21:698. [PMID: 33836711 PMCID: PMC8034165 DOI: 10.1186/s12889-021-10704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Both the presence of psychological problems and the absence of an employment contract are related to long-term sickness absence, prolonged work disability and unemployment. Studies researching the effectiveness of return-to-work interventions on these non-permanent workers, including unemployed and temporary agency workers and workers with an expired fixed-term contract, are lagging behind. Therefore, a return-to-work intervention called “Brainwork” was developed. The aim of this study was to assess the effectiveness of the ‘Brainwork Intervention’ in reducing the duration of sick leave compared to usual care over a 12-month follow-up. Methods In a multicenter controlled clinical trial, using a quasi-randomization procedure, we compared the Brainwork Intervention (n = 164) to usual care (n = 156). The primary outcome was the duration of sick leave. Secondary outcomes were the duration of sick leave starting from Social Security Agency transfer; the proportion of workers returned to work; the number of hours of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. Protocol adherence (Brainwork Intervention) was considered sufficient when at least three of the five protocol steps were followed. Cox regressions, linear and ordinal regression, and Mixed Model analyses were performed. Results All 320 participants were analyzed. The Brainwork Intervention resulted in a non-significant reduction of the duration of sick leave compared to usual care (269 days versus 296 days; HR = 1.29; 95% CI 0.94–1.76; p = 0.11). For those working (46%) during the 12-month follow-up, the mean number of hours of paid employment was non-significantly higher in the usual care group (682 h versus 493 h; p = 0.053). No significant differences were found for other secondary outcomes. Protocol adherence was 10%. Conclusions The Brainwork Intervention as performed with a low protocol adherence did not result in a significant reduction of the duration of sick leave compared to usual care. It remains unclear what the results would have been if the Brainwork Intervention had been executed according to protocol. Trial registration The Netherlands Trial Register (NTR); NTR3976 (old registration number NTR4190). Registered September 27th 2013. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10704-0.
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Affiliation(s)
- Selwin S Audhoe
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Jan L Hoving
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Bonne J H Zijlstra
- Faculty of Behavioral and Social Sciences, University of Amsterdam, Research Institute of Child Development and Education, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
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Zapata-Ospina JP, Sierra-Muñoz JS, Cardeño-Castro CA. [Diagnosis and treatment of adjusment disorder in primary care]. Semergen 2020; 47:197-206. [PMID: 33214076 DOI: 10.1016/j.semerg.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
Adjustment disorder (AD) corresponds to the combination of affective, cognitive and behavioral symptoms that appear after a stressful event. It is a frequent reason for consultation in primary care and is one of the most common diagnoses in suicide attempts attended in the emergency department. Its essential feature is that the symptoms must appear in direct relation to an event perceived as stressful, so it tends to be transitory if the event ceases or the patient adapts. The mainstay of treatment are psychosocial interventions, aimed at modifying the event or its consequences, supporting adaptation and optimizing resources to cope with the event. However, prescription of psychotropic drugs is favored in practice, when its use should be limited to symptomatic relief. This highlights the need to properly identify and treat it. This article presents the strategies for diagnosis and treatment of AD in primary care.
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Affiliation(s)
- J P Zapata-Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - J S Sierra-Muñoz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - C A Cardeño-Castro
- Servicio de Psiquiatría de Enlace, Hospital Universitario San Vicente Fundación, Medellín, Colombia
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21
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Marois E, Durand MJ, Coutu MF. Logic models for the Therapeutic Return-to-Work Program as adapted for common mental disorders: A guide for health professionals. Work 2020; 67:345-358. [PMID: 33044215 DOI: 10.3233/wor-203284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Workplace interventions are recommended for workers with common mental disorders, but knowledge of their action mechanisms and operationalization remains limited. The Therapeutic Return-to-Work Program, developed for workers with musculoskeletal disorders, is recommended for common mental disorders. OBJECTIVE Our objective was to adapt this program's logic models to common mental disorders. METHODS A program logic analysis was conducted using a literature review and a two-phase group consensus method. We submitted a preliminary adapted version of the program's logic models and two questionnaires to health professional experts who participated in two group sessions, ultimately to produce the final version of the models. RESULTS We consulted 86 publications. The health professional experts (N = 7) had overall mean agreement scores of respectively 4.10/5 and 3.89/5 for questions on the program's theoretical and operational models. The final version of the logic models adapted for common mental disorders included four specific and 15 intermediate objectives, three main components, one optional component, four key processes, and 44 tasks. CONCLUSION The adapted logic models for the Therapeutic Return-to-Work Program show the relevance of the original objectives and components for common mental disorders. The next step will involve evaluating its feasibility with other stakeholders (insurers, employers, unions, workers).
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Affiliation(s)
- Elyse Marois
- Université de Sherbrooke, Health Sciences Program -Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, Canada.,Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada
| | - Marie-José Durand
- Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada.,Université de Sherbrooke -School of Rehabilitation, Longueuil, Quebec, Canada
| | - Marie-France Coutu
- Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada.,Université de Sherbrooke -School of Rehabilitation, Longueuil, Quebec, Canada
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Return to Work after Common Mental Disorders: A Qualitative Study Exploring the Expectations of the Involved Stakeholders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186635. [PMID: 32932972 PMCID: PMC7558125 DOI: 10.3390/ijerph17186635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 12/14/2022]
Abstract
Common mental disorders (CMDs) are risk factors for long-term sickness absence and unemployment. Therefore, return-to-work (RTW) processes have been introduced to facilitate the return of employees. As the success of RTW processes is considered to be determined by the cooperativeness of the involved stakeholders, we aimed to investigate the views of those stakeholders to disclose potentially diverging expectations. Qualitative interviews were conducted (08/2018-04/2019) among five stakeholder groups: returnees with a diagnosed CMD who were eligible for a RTW process; health care professionals nominated by the returnees; supervisors, colleagues and occupational physicians (the latter three groups were not nominated by the returnees). In total, 24 returnees, 13 health care professionals, 13 occupational physicians, 9 supervisors and 9 colleagues were interviewed (68 interviews in total). Potentially diverging expectations of the stakeholders related to whether diagnoses need to be disclosed by returnees. Agreement existed in terms of the need for a trustful relationship between employees and occupational physicians to initiate a RTW process early. As the understanding of all stakeholders' viewpoints is one of the main factors promoting a successful RTW, we explored the expectations of those involved in the RTW process. One implication of our findings is to strengthen the role of occupational physicians, who could coordinate the return process.
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Casey P, Pillay D, Wilson L, Maercker A, Rice A, Kelly B. Pharmacological interventions for adjustment disorders in adults. Hippokratia 2020. [DOI: 10.1002/14651858.cd010530.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Patricia Casey
- Department of Psychiatry; University College Dublin; Dublin Ireland
- Mater Misericordiae University Hospital; Dublin Ireland
| | - Divina Pillay
- Department of Psychiatry; University College Dublin; Dublin Ireland
- Mater Misericordiae University Hospital; Dublin Ireland
| | - Lorna Wilson
- Department of Psychiatry; University College Dublin; Dublin Ireland
- Mater Misericordiae University Hospital; Dublin Ireland
| | - Andreas Maercker
- Department of Psychology; University of Zurich; Zurich Switzerland
| | - Angela Rice
- Library and Information Service; Mater Misericordiae University Hospital; Dublin Ireland
| | - Brendan Kelly
- Department of Psychiatry; University College Dublin; Dublin Ireland
- Mater Misericordiae University Hospital; Dublin Ireland
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Cederberg M, Ali L, Ekman I, Glise K, Jonsdottir IH, Gyllensten H, Swedberg K, Fors A. Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE). BMJ Open 2020; 10:e037515. [PMID: 32873675 PMCID: PMC7467509 DOI: 10.1136/bmjopen-2020-037515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/27/2020] [Accepted: 07/31/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person-centred care (PCC) has previously shown positive effects on self-efficacy however this needs to be further investigated in relation to patients with CMDs and in an eHealth context. METHODS AND ANALYSIS This study is an open randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care plus PCC by telephone and a digital platform. The primary outcome measure is a composite score of changes in sick leave and self-efficacy. Participants will include 220 primary care patients on sick leave due to CMDs and data will mainly be collected through questionnaires at baseline and 3, 6, 12 and 24 months from the inclusion date. Inclusion is ongoing and expected to be completed during the fall of 2020. A process and health economic evaluation will also be conducted. ETHICS AND DISSEMINATION This study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be published in peer-reviewed scientific journals and presented at national and international scientific conferences. This project is part of a broader research programme conducted at the Gothenburg Centre for Person-Centred Care (GPCC), where extensive work is undertaken to disseminate knowledge on and implementation of PCC. TRIAL REGISTRATION NUMBER NCT03404583.
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Affiliation(s)
- Matilda Cederberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Psychiatric department, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Östra, Gothenburg, Sweden
| | - Kristina Glise
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Karl Swedberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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25
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Corbière M, Mazaniello-Chézol M, Bastien MF, Wathieu E, Bouchard R, Panaccio A, Guay S, Lecomte T. Stakeholders' Role and Actions in the Return-to-Work Process of Workers on Sick-Leave Due to Common Mental Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:381-419. [PMID: 31673934 DOI: 10.1007/s10926-019-09861-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The lack of knowledge regarding the roles and actions of return to work (RTW) stakeholders create confusion and uncertainty about how and when to RTW after experiencing a common mental disorder (CMD). Purpose The purpose of this scoping review is to disentangle the various stakeholders' role and actions in the RTW process of workers on sick-leave due to CMDs. The research question is: What is documented in the existing literature regarding the roles and actions of the identified stakeholders involved in the RTW process of workers on sick-leave due to CMDs? Methods In conducting this scoping review, we followed Arksey and O'Malley's (Int J Soc Res Methodol 8:19-32, 2005) methodology, consisting of different stages (e.g., charting the data by categorizing key results). Results 3709 articles were screened for inclusion, 243 of which were included for qualitative synthesis. Several RTW stakeholders (n=11) were identified (e.g., workers on sick leave due to CMDs, managers, union representatives, rehabilitation professionals, insurers, return to work coordinators). RTW stakeholders' roles and actions inter- and intra-system were recommended, either general (e.g., know and understand the perspectives of all RTW stakeholders) or specific to an actor (e.g., the return to work coordinator needs to create and maintain a working alliance between all RTW stakeholders). Furthermore, close to 200 stakeholders' actions, spread out on different RTW phases, were recommended for facilitating the RTW process. Conclusions Eleven RTW stakeholders from the work, heath and insurance systems have been identified, as well as their respective roles and actions. Thanks to these results, RTW stakeholders and policy makers will be able to build practical relationships and collaboration regarding the RTW of workers on sick leave due to CMDs.
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Affiliation(s)
- Marc Corbière
- Department of Education, Career counselling, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montreal, QC, H3C 3P8, Canada.
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada.
| | - Maud Mazaniello-Chézol
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Marie-France Bastien
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Estelle Wathieu
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Art History, Concordia University, Montreal, QC, Canada
| | | | - Alexandra Panaccio
- John Molson School of Business, Concordia University, Montréal, QC, Canada
| | - Stéphane Guay
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychiatry and Addictology, Université de Montreal, Montreal, QC, Canada
| | - Tania Lecomte
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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26
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Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145234. [PMID: 32698470 PMCID: PMC7400406 DOI: 10.3390/ijerph17145234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/03/2020] [Accepted: 07/16/2020] [Indexed: 02/03/2023]
Abstract
The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer's perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer's perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.
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Keus van de Poll M, Nybergh L, Lornudd C, Hagberg J, Bodin L, Kwak L, Jensen I, Lohela-Karlsson M, Torgén M, Bergstrom G. Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services. Occup Environ Med 2020; 77:454-461. [PMID: 32291291 PMCID: PMC7306872 DOI: 10.1136/oemed-2019-106353] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Common mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms. METHODS Randomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee's manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health. RESULTS A statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences. CONCLUSION PSI was effective in reducing sickness absence which was the primary outcome in this study.
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Affiliation(s)
- Marijke Keus van de Poll
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Lotta Nybergh
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Caroline Lornudd
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden
| | - Jan Hagberg
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Lennart Bodin
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Lydia Kwak
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Irene Jensen
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Margareta Torgén
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunnar Bergstrom
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
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Persson R, Österberg K. Repeated assessment of work-related exhaustion: the temporal stability of ratings in the Lund University Checklist for Incipient Exhaustion. BMC Res Notes 2020; 13:304. [PMID: 32586364 PMCID: PMC7318754 DOI: 10.1186/s13104-020-05142-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/16/2020] [Indexed: 01/09/2023] Open
Abstract
Objective Screening inventories are important tools in clinical settings and research but may be sensitive to temporary fluctuations. Therefore, we revisited data from a longitudinal study with the Lund University Checklist for Incipient Exhaustion (LUCIE) that comprised occupationally active individuals (n = 1355; 27–52 years; 57% women) and one initial paper and pencil survey and 10 subsequent equally spaced online surveys. In the present study we examine to what extent the LUCIE scores changed across 3 years (11 assessments) and whether episodes of temporary elevated LUCIE scores (LTE) coincided with reports of negative or positive changes at work or in private life. Results In the total sample, the prevalence rates for the four LUCIE classifications of signs of increasing exhaustion (from no exhaustion to possible exhaustion disorder) ranged from 65.4–73.0%, 16.6–20.9%, 6.2–9.6%, and 3.4–5.0%. Of 732 individuals screened for LTE episodes, 16% had an LTE episode. The LTE episodes typically coincided with reports of adverse changes at work or, to a lesser extent, in private life. Thus, LUCIE classifications appear reliable and lend themselves to repeated use on the same individuals, or group of individuals. Even single episodes of elevated LUCIE scores seem appropriately to indicate adverse reactions to the work situation.
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Affiliation(s)
- Roger Persson
- Department of Psychology, Lund University, Lund, 22100, Sweden. .,Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, 22185, Sweden.
| | - Kai Österberg
- Department of Psychology, Lund University, Lund, 22100, Sweden.,Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, 22185, Sweden
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Perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries. Int J Ment Health Syst 2020; 14:26. [PMID: 32256689 PMCID: PMC7106860 DOI: 10.1186/s13033-020-00354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 03/10/2020] [Indexed: 11/14/2022] Open
Abstract
Background Mental disorders affect employment and the ability to work, and mental healthcare providers are important in the promotion of health and employment for affected individuals. The objective of this study is to explore the perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries. Methods Our study participants included mental healthcare providers (psychiatrists, occupational physicians, psychologists, and social care workers) from Kenya and Nigeria. Qualitative interviews and a focus group discussion were conducted with 15 professionals in Kenya and online questionnaires were completed by 80 professionals from Nigeria. Results The study participants suggested that work is important for the recovery and wellbeing of persons with mental disorders. A complex interplay of factors related to the health of persons with mental disorders and the socioeconomic system in their setting were identified as barriers to their work ability and employment. Participants proposed four pathways to improved employment: including information on reducing stigma, better healthcare, policy advocacy in employment, and government commitment to healthcare and social welfare. Public education to reduce stigma and better healthcare were the highest reported facilitators of employment. Conclusions Persons with mental disorders require multilevel support and care in obtaining and retaining employment. A better mental healthcare system is essential for the employment of persons with mental disorders.
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Axén I, Björk Brämberg E, Vaez M, Lundin A, Bergström G. Interventions for common mental disorders in the occupational health service: a systematic review with a narrative synthesis. Int Arch Occup Environ Health 2020; 93:823-838. [PMID: 32246230 PMCID: PMC7452923 DOI: 10.1007/s00420-020-01535-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/12/2020] [Indexed: 12/14/2022]
Abstract
Introduction Common mental disorders (CMD) are leading causes of decreased workability in Sweden and worldwide. Effective interventions to prevent or treat such disorders are important for public health. Objective To synthesize the research literature regarding occupational health service (OHS) interventions targeting prevention or reduction of CMD among employees. The effect on workability (sickness absence, return-to-work and self-reported workability) and on CMD symptoms was evaluated in a narrative analysis. Data sources The literature search was performed in four electronic databases in two searches, in 2014 and in 2017. Eligibility criteria (using PICO) Population: studies investigating employees at risk or diagnosed with CMD, as well as preventive workplace intervention targeting mental health. Intervention: studies where the recruitment or the intervention was delivered by the OHS or OHS personnel were included. Control: individuals or groups who did not receive the target intervention. Outcome: all types of outcomes concerning sickness absence and psychological health were included. Study quality was assessed using a Swedish AMSTAR-based checklist, and results from studies with low or medium risk of bias were narratively synthesized based on effect or absence thereof. Results Thirty-three studies were included and assessed for risk of bias. Twenty-one studies had low or medium risk of bias. In 18 studies, rehabilitation interventions were evaluated, 11 studies concerned interventions targeting employees at risk for developing CMD and four studies investigated preventive interventions. Work-focused cognitive behavioral therapy and problem-solving skill interventions decreased time to first return-to-work among employees on sick leave for CMD in comparison with treatment-as-usual. However, effect on return to full-time work was not consistent, and these interventions did not consistently improve CMD symptoms. Selective interventions targeting employees at risk of CMD and preventive interventions for employees were heterogeneous, so replication of these studies is necessary to evaluate effect. Limitations Other workplace interventions outside the OHS may have been missed by our search. There was considerable heterogeneity in the included studies, and most studies were investigating measures targeting the individual worker. Interventions at the workplace/organizational level were less common. Conclusions and implication of key findings Return-to-work and improvement of CMD symptoms are poorly correlated and should be addressed simultaneously in future interventions. Further, interventions for CMD administered through the occupational health service require further study. Rehabilitative and preventive strategies should be evaluated with scientifically robust methods, to examine the effectiveness of such interventions.
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Affiliation(s)
- Iben Axén
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Elisabeth Björk Brämberg
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 405 30, Gothenburg, Sweden
| | - Marjan Vaez
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Andreas Lundin
- Department for Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gunnar Bergström
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Occupational Health Sciences and Psychology, University of Gävle Centre for Musculoskeletal Research, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
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Tarro L, Llauradó E, Ulldemolins G, Hermoso P, Solà R. Effectiveness of Workplace Interventions for Improving Absenteeism, Productivity, and Work Ability of Employees: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1901. [PMID: 32183392 PMCID: PMC7142489 DOI: 10.3390/ijerph17061901] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/26/2020] [Accepted: 03/10/2020] [Indexed: 12/20/2022]
Abstract
To determine the effectiveness of workplace interventions and the most effective methodological design for the improvement of employee productivity, work ability, and absenteeism. A meta-analysis of randomized controlled trials (RCTs) of workplace interventions was conducted (PROSPERO, CRD42018094083). The PubMed, Scopus, PsycINFO, and Cochrane databases were searched. RCTs from 2000 to 2017 and with employees (18-65 years) were selected. Then, intervention characteristics and work-related outcomes data were extracted. A total of 47 RCTs were included in the systematic review, and 19 RCTs (11 absenteeism, 7 productivity, and 5 work ability) were included in the meta-analysis. The meta-analysis showed that the effectiveness of workplace interventions for absenteeism was -1.56 (95% CI, -2.67 to -0.44) and -2.65 (95% CI, -4.49 to -0.81) considering only moderate quality RCTs. In contrast, only a few studies of workplace interventions for productivity and work ability were included, which was insufficient for determining the effectiveness and best design for improving these work outcomes. The workplace is an interesting environment to reduce absenteeism, and individualized and counseling interventions with <10 sessions/total were the most effective workplace intervention methodological design for reducing the absenteeism of employees. Future high-quality RCTs that also consider health risks should be implemented to strengthen the results.
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Affiliation(s)
- Lucia Tarro
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, 43201 Reus, Spain;
- Technological Unit of Nutrition and Health, EURECAT-Technology Centre of Catalonia, 43204 Reus, Spain
| | - Elisabet Llauradó
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, 43201 Reus, Spain;
| | - Gemma Ulldemolins
- Activa Mutua, Mutua Colaboradora con la Seguridad Social, Tarragona, 43204 Catalonia, Spain; (G.U.); (P.H.)
| | - Pedro Hermoso
- Activa Mutua, Mutua Colaboradora con la Seguridad Social, Tarragona, 43204 Catalonia, Spain; (G.U.); (P.H.)
| | - Rosa Solà
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, 43201 Reus, Spain;
- Technological Unit of Nutrition and Health, EURECAT-Technology Centre of Catalonia, 43204 Reus, Spain
- Hospital Universitari Sant Joan de Reus, Internal medicine department IISPV, Reus, 43204 Catalonia, Spain
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Spronken M, Brouwers EPM, Vermunt JK, Arends I, Oerlemans WGM, van der Klink JJL, Joosen MCW. Identifying return to work trajectories among employees on sick leave due to mental health problems using latent class transition analysis. BMJ Open 2020; 10:e032016. [PMID: 32107267 PMCID: PMC7202700 DOI: 10.1136/bmjopen-2019-032016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/04/2019] [Accepted: 01/22/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To develop effective return to work (RTW) interventions for employees on sick leave due to mental health problems (MHPs), a better understanding of individual variation in the RTW process is needed. We investigated which RTW trajectories can be identified among employees with MHPs in terms of RTW duration and relapse occurrence during the RTW process. Additionally, we examined how different RTW trajectories can be described in terms of personal and work characteristics. METHODS Longitudinal sickness absence registry data were collected retrospectively from the largest Dutch occupational health service. Quantitative RTW information as well as personal and work characteristics were extracted. In total, 9517 employees with a sickness absence due to MHPs were included in the analyses (62 938 data points; RTW durations from 29 to 730 days). RESULTS A latent class transition analysis revealed five distinct RTW trajectories, namely (1) fast RTW with little chance of relapse, (2) slow RTW with little chance of relapse, (3) fast RTW with considerable chance of relapse, (4) slow RTW with considerable chance of relapse and (5) very fast RTW with very small chance of relapse. Differences between employees in the slower and faster trajectories were observed regarding gender, age, type of MHP, organisation sector and organisation size but not regarding part-time work. CONCLUSIONS RTW trajectories among employees with MHPs showed large individual variability and differed on personal and work characteristics. Knowledge on different RTW trajectories and their characteristics contributes to the development of personalised RTW treatments, tailored to specific individuals and organisations.
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Affiliation(s)
- Maitta Spronken
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Evelien P M Brouwers
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Jeroen K Vermunt
- Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Iris Arends
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Wido G M Oerlemans
- Research and Business Development, HumanTotalCare, Utrecht, The Netherlands
- Organisational Dynamics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jac J L van der Klink
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Margot C W Joosen
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Winter L, Geldmacher J, Plücker-Boss K, Kahl KG. Integration of a Return-to-Work Module in Cognitive Behavioral Therapy in Patients With Major Depressive Disorder and Long-Term Sick Leave-A Feasibility Study. Front Psychiatry 2020; 11:512. [PMID: 32581884 PMCID: PMC7283451 DOI: 10.3389/fpsyt.2020.00512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 05/19/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Major depressive disorder (MDD) has a negative impact on individuals ability to work, and is often associated with long phases of sick leave. Consequently, interventions facilitating return to work in patients with MDD gained increased attention during last decades. We here report results of a feasibility study where a "return-to-work" (RTW) module published by Lagerveld and colleagues in the Netherlands was integrated in cognitive behavioral therapy in depressed patients with long-term sick leaves in Germany. Our study aimed to answer the following questions: Is RTW accepted by patients and therapists? Do RTW interventions lead to return-to-work? Do depressive symptoms improve? METHODS Twenty patients with MDD (15 female; mean age, 45 ± 9 years) were included. Patients received cognitive-behavioral therapy with an integrated, standardized return-to-work module (W-CBT). Psychometric measurements included Beck Depression Inventory (BDI-2) and work ability index (WAI). Further, time until return-to-work was measured, and acceptability of W-CBT was assessed using visual analog scales and open questions. RESULTS Mean sick leave days in depressed patients were 127 ± 97, and 75% of patients were sick leave for more than 6 weeks. After treatment, 11/20 patients had returned to their former occupation (55%), 5/20 were in occupational re-deployment or started a new job (25%), and 3/20 patients were still on sick leave (2/20; 10%) or received a pension (1/20; 5%). One patient dropped out. BDI-2 sum score improved from 23 ± 8 to 8 ± 5 (p < 0.001), and WAI improved from 28 ± 6 to 39 ± 7 (p < 0.001). Acceptability of W-CBT in patients and therapists was high. CONCLUSION We here demonstrate feasibility and acceptability of an RTW module integrated in standard cognitive behavioral therapy. W-CBT leads to improvement of work ability, paralleled by improvement of depressive symptoms. Despite the limitations of this uncontrolled study, the results propose that W-CBT may be feasible in the treatment of depressed patients with long sick leaves and justify a controlled trial evaluating the efficacy of W-CBT.
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Affiliation(s)
- Lotta Winter
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Julia Geldmacher
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Katharina Plücker-Boss
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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van Heijst BF, Deserno MK, Rhebergen D, Geurts HM. Autism and depression are connected: A report of two complimentary network studies. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:680-692. [PMID: 31709804 PMCID: PMC7168804 DOI: 10.1177/1362361319872373] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autism and depression often co-occur. Through network analysis, we seek to gain a better understanding of this co-occurrence by investigating whether (1) autism and depression share overlapping groups of symptoms and/or (2) are connected through a bridge of mastery or worry symptoms. This is addressed in two complimentary studies: (1) Study 1 focusing on depressed (N = 258) and non-depressed adults (N = 117), aged 60-90 years; (2) Study 2 focusing on autistic (N = 173) and non-autistic adults (N = 70), aged 31-89 years. Self-report questionnaire data were collected on autistic traits (AQ-28), depression symptoms (Study 1: Inventory of Depressive Symptomatology Self Report; Study 2: Symptom Checklist 90-Revised depression subscale), worry (Worry Scale-R) and mastery (the Pearlin Mastery Scale). For both studies, data were analysed by creating glasso networks and subsequent centrality analyses to identify the most influential variables in the respective networks. Both depressed and autistic adults are highly similar in the perceived amount of worries and lack of control. While caution is needed when interpreting the pattern of findings given the bootstrapping results, findings from both studies indicate that overlapping symptoms do not fully explain the co-occurrence of autism and depression and the perception of having control over your life, that is, mastery seems a relevant factor in connecting autism and depression.
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Affiliation(s)
| | - Marie K Deserno
- University of Amsterdam, The Netherlands.,Dr. Leo Kannerhuis, The Netherlands
| | - Didi Rhebergen
- Amsterdam Public Health Research Institute, The Netherlands.,GGZ inGeest Specialized Mental Health Care, The Netherlands
| | - Hilde M Geurts
- University of Amsterdam, The Netherlands.,Dr. Leo Kannerhuis, The Netherlands
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Salomonsson S, Santoft F, Lindsäter E, Ejeby K, Ingvar M, Ljótsson B, Öst LG, Lekander M, Hedman-Lagerlöf E. Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial. Scand J Psychol 2019; 61:281-289. [PMID: 31691305 DOI: 10.1111/sjop.12590] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/16/2019] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder.
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Affiliation(s)
- Sigrid Salomonsson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Santoft
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Elin Lindsäter
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Kersti Ejeby
- Department of Neurobiology, Division of Family medicine, Care Sciences and Society (NVS), H1, Karolinska Institutet, Stockholm, Sweden
| | - Martin Ingvar
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Göran Öst
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
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36
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Quero S, Rachyla I, Molés M, Mor S, Tur C, Cuijpers P, López-Montoyo A, Botella C. Can Between-Session Homework Be Delivered Digitally? A Pilot Randomized Clinical Trial of CBT for Adjustment Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3842. [PMID: 31614596 PMCID: PMC6843437 DOI: 10.3390/ijerph16203842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/28/2019] [Accepted: 10/08/2019] [Indexed: 12/20/2022]
Abstract
Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet.
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Affiliation(s)
- Soledad Quero
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain.
| | - Iryna Rachyla
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Mar Molés
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Sonia Mor
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Cintia Tur
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081BT Amsterdam, The Netherlands.
| | - Alba López-Montoyo
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Cristina Botella
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain.
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Santoft F, Salomonsson S, Hesser H, Lindsäter E, Ljótsson B, Lekander M, Kecklund G, Öst LG, Hedman-Lagerlöf E. Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout. Behav Ther 2019; 50:475-488. [PMID: 31030867 DOI: 10.1016/j.beth.2018.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 08/15/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022]
Abstract
Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017, 95% CIasymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CIasymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.
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Brenninkmeijer V, Lagerveld SE, Blonk RWB, Schaufeli WB, Wijngaards-de Meij LDNV. Predicting the Effectiveness of Work-Focused CBT for Common Mental Disorders: The Influence of Baseline Self-Efficacy, Depression and Anxiety. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:31-41. [PMID: 29450678 DOI: 10.1007/s10926-018-9760-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose This study examined who benefits most from a cognitive behavioural therapy (CBT)-based intervention that aims to enhance return to work (RTW) among employees who are absent due to common mental disorders (CMDs) (e.g., depression, anxiety, or adjustment disorder). We researched the influence of baseline work-related self-efficacy and mental health (depressive complaints and anxiety) on treatment outcomes of two psychotherapeutic interventions. Methods Using a quasi-experimental design, 12-month follow-up data of 168 employees were collected. Participants either received work-focused cognitive behavioural therapy (W-CBT) that integrated work aspects early into the treatment (n = 89) or regular cognitive behavioural therapy (R-CBT) without a focus on work (n = 79). Results Compared with R-CBT, W-CBT resulted in a faster partial RTW, irrespective of baseline self-efficacy. Among individuals with high self-efficacy, W-CBT also resulted in faster full RTW. The effectiveness of W-CBT on RTW did not depend on baseline depressive complaints or anxiety. The decline of mental health complaints did not differ between the two interventions, nor depended on baseline self-efficacy or mental health. Conclusions Considering the benefits of W-CBT for partial RTW, we recommend this intervention as a preferred method for employees with CMDs, irrespective of baseline self-efficacy, depression and anxiety. For individuals with high baseline self-efficacy, this intervention also results in higher full RTW. For those with low self-efficacy, extra exercises or components may be needed to promote full RTW.
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Affiliation(s)
- Veerle Brenninkmeijer
- Department of Social, Health and Organizational Psychology, Utrecht University, PO Box 80.140, 3508 TC, Utrecht, The Netherlands.
| | - Suzanne E Lagerveld
- Department of Social, Health and Organizational Psychology, Utrecht University, PO Box 80.140, 3508 TC, Utrecht, The Netherlands
- Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- ZINZIZ BV, Utrecht, The Netherlands
| | | | - Wilmar B Schaufeli
- Department of Social, Health and Organizational Psychology, Utrecht University, PO Box 80.140, 3508 TC, Utrecht, The Netherlands
- Research Unit Occupational & Organizational Psychology and Professional Learning, University of Leuven, Leuven, Belgium
| | - Leoniek D N V Wijngaards-de Meij
- Department of Social, Health and Organizational Psychology, Utrecht University, PO Box 80.140, 3508 TC, Utrecht, The Netherlands
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Frith E, Ramulu PY, Ashar B, Loprinzi PD. Association of Single and Multiple Medical Conditions with Work Status among Adults in the United States. J Lifestyle Med 2019; 9:15-26. [PMID: 30918830 PMCID: PMC6425902 DOI: 10.15280/jlm.2019.9.1.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 06/10/2018] [Indexed: 11/22/2022] Open
Abstract
Background The purpose of this study was to comprehensively examine the association of a multitude of individual medical conditions, as well as multimorbidity, on work status among a national sample of U.S. adults. Methods The present study included 7 cycles (1999–2012) from the National Health and Nutrition Examination Survey (N = 28,119). Results In total, 26 medical conditions increased the odds of not working. Multimorbidity as well as having prevalent medical condition(s) within each of the Cumulative Index Rating Scale Morbidity Classes were associated with increased odds of not working. Few medical conditions were associated with higher odds of working part-time (vs. full-time) or unemployment (vs. working). Conclusion These findings underscore the importance of instating comprehensive worksite wellness health promotion policies, as well as providing individuals with resources to preserve and enhance personal health.
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Affiliation(s)
- Emily Frith
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, USA
| | | | - Bimal Ashar
- Division of General Internal Medicine, Johns Hopkins Hospital, School of Medicine, Baltimore, MD, USA
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, USA
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Aasdahl L, Fimland MS. Is there really a "golden hour" for work disability interventions? A narrative review. Disabil Rehabil 2019; 42:586-593. [PMID: 30602340 DOI: 10.1080/09638288.2018.1503735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The subacute phase of low back pain has been termed as the "golden hour" to intervene to prevent work disability. This notion is based on the literature up to 2001 and is limited to back pain. In this narrative review, we examined whether the current literature indicate an optimal time for return to work (RTW) interventions. We considered randomized controlled trials published from 1997 to April 2018 assessing effects of occupational rehabilitation interventions for musculoskeletal complaints (15 included), mental health disorders (9 included) or a combination of the two (1 included). We examined participants' sick leave duration at inclusion and the interventions' effects on RTW. Most studies reporting an effect on RTW included participants with musculoskeletal complaints in the subacute phase, supporting that this phase could be a beneficial time to start RTW-interventions. However, recent studies suggest that RTW-interventions also can be effective for workers with longer sick leave durations. Our interpretation is that there might not be a limited time window or "golden hour" for work disability interventions, but rather a question about what type of intervention is right at what time and for whom. However, more research is needed. Particularly, we need more high-quality studies on the effects of RTW-interventions for sick listed individuals with mental health disorders.Implications for rehabilitationThe subacute phase of low back pain has been termed the "golden hour" for work disability prevention.Recent evidence suggests there is a wider time-window for effective interventions, both for musculoskeletal- and common mental disorders.A stepped-care approach, starting with simpler low-cost interventions (e.g., brief reassuring interventions), before considering more comprehensive interventions (e.g., multimodal rehabilitation), could facilitate return to work and avoid excessive treatment.
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Affiliation(s)
- Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Marius Steiro Fimland
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Doki S, Harano S, Shinada K, Ohyama A, Kojimahara N. [Return-to-work support programs for workers on sick leave: a systematic review and meta-analysis]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2018; 60:169-179. [PMID: 30369589 DOI: 10.1539/sangyoeisei.2018-008-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We are responsible for answering the research question, "Does a return-to-work program improve the returning outcome?" This is one of the six research questions in the evidence-based "Return-to-work Guidance in Occupational Health 2017" developed by the Kanto branch of the Japanese Society of Occupational Health. This study aimed to integrate the effectiveness of the return-to-work program to improve the state of sick-listed employees suffering from cardiovascular disease, cancer, and musculoskeletal and mental health problems. METHODS Three different databases, PubMed, Cochrane Library, and Ichushi-Web were searched. Based on the results of a systematic review, the guidance developing group created the draft of the recommendations with evidence to decision framework and used a poll to determine the recommendations. We integrated the evidence from a systematic review and meta-analysis at the disease level. This study protocol was registered with PROSPERO (the registration number is: CRD42016048937). RESULTS A total of five articles on musculoskeletal diseases and six on mental health problems were retrieved. No articles in the cardiovascular and cancer areas matched the eligibility criteria. When workers suffered from musculoskeletal disorders, the rehabilitation group statistically returned to work earlier than the usual care group did [HR 1.58 (95% CI 1.26-1.97), -40.71days (95% CI -60.69--20.72) ]. In the mental health problems group, the psychological intervention program group had statistically less days of sick leaves as compared to that in the usual care group [-18.64 days (95% CI -27.98--9.30) ]. CONCLUSIONS It might be suggested that work environment management, work management, tackling psychological problems, cognitive behavioral approach, and several meetings with supervisors and occupational health staff, in addition to a direct focus on backache contributed to the early return-to-work of workers suffering from musculoskeletal disease. Regarding mental health problems, interviews with a psychological approach and consultations with psychologists and psychiatrists might be effective in reducing the days of sick leaves. However, because these methods were investigated in Europe, we need to be careful when introducing these practises in Japan due to the differences in the occupational health support systems. Further, high quality evidence level studies are needed in Japan.
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Affiliation(s)
| | | | - Kayoko Shinada
- Department of Oral Health Promotion, Graduate School, Tokyo Medical and Dental University
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Contreary K, Ben-Shalom Y, Gifford B. Using Predictive Analytics for Early Identification of Short-Term Disability Claimants Who Exhaust Their Benefits. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:584-596. [PMID: 30386976 DOI: 10.1007/s10926-018-9815-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose Early interventions can help short-term disability insurance (STDI) claimants return to work following onset of an off-the-job medical condition. Accurately targeting such interventions involves identifying claimants who would, without intervention, exhaust STDI benefits and transition to longer-term support. We identify factors that predict STDI exhaustion and transfer to long-term disability insurance (LTDI). We also explore whether waiting for some claims to resolve without intervention improves targeting efficiency. Methods We use a large database of STDI claims from private employer-sponsored disability insurance programs in the United States to predict which claims will exhaust STDI or transition to LTDI. We use a split sample approach, conducting logistic regressions on half of our data and generating predictions for the other half. We assess predictive accuracy using ROC curve analysis, repeating on successive subsamples, omitting claims that resolve within 2, 4, and 6 weeks. Results Age, primary diagnosis, and employer industry were associated with the two outcomes. Rapid attrition of short-duration claims from the sample means that waiting can substantially increase the efficiency of targeting efforts. Overall accuracy of classification increases from 63.2% at week 0 to 82.9% at week 6 for exhausting STDI benefits, and from 63.7 to 83.0% for LTDI transfer. Conclusions Waiting even a few weeks can substantially increase the accuracy of early intervention targeting by allowing claims that will resolve without further intervention to do so. Predictive modeling further narrows the target population based on claim characteristics, reducing intervention costs. Before adopting a waiting strategy, however, it is important to consider potential trade-offs involved in delaying the start of any intervention.
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Affiliation(s)
- Kara Contreary
- Mathematica Policy Research, 505 14th Street, Suite 800, Oakland, CA, 94612, USA.
| | - Yonatan Ben-Shalom
- Mathematica Policy Research, 1100 1st Street, NE, 12th Floor, Washington, DC, 20002, USA
| | - Brian Gifford
- Integrated Benefits Institute, 595 Market Street, Suite 810, San Francisco, CA, 94105, USA
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Finnes A, Enebrink P, Ghaderi A, Dahl J, Nager A, Öst LG. Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials. Int Arch Occup Environ Health 2018; 92:273-293. [PMID: 30474734 PMCID: PMC6420449 DOI: 10.1007/s00420-018-1380-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 11/04/2018] [Indexed: 12/27/2022]
Abstract
Purpose Common mental disorders (CMDs) and musculoskeletal disorders are highly prevalent in the population and cause significant distress and disability, and high costs to society. The main objective of this systematic review and meta-analysis was to examine the outcome and comparative effectiveness of psychological interventions in reducing sickness absence (SA) due to CMDs or musculoskeletal disorders, compared to a waitlist control group, usual care or another clinical intervention. Methods We reviewed 3515 abstracts of randomized controlled trials published from 1998 to 2017. Of these, 30 studies were included in the analysis. Results The psychological interventions were overall more effective than treatment as usual in reducing SA (small effect sizes), but not compared to other clinical interventions. Results were similar for studies on CMDs and musculoskeletal pain. A few significant moderating effects were found for treatment-specific variables. However, these were difficult to interpret as they pointed in different directions. Conclusion There was a small but significant effect of psychological treatments in reducing SA. We identified areas of improvement such as methodological problems among the included studies and failure to specifically address RTW in the interventions that were evaluated. Clinical implications of the findings, and ways of improving methodological rigour of future studies are discussed. Electronic supplementary material The online version of this article (10.1007/s00420-018-1380-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Finnes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden.
| | - Pia Enebrink
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden
| | - JoAnne Dahl
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
| | - Anna Nager
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Riddarstigen 30, Täby, 183 30, Stockholm, Sweden
| | - Lars-Göran Öst
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden
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44
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Quero S, Molés M, Campos D, Andreu‐Mateu S, Baños RM, Botella C. An adaptive virtual reality system for the treatment of adjustment disorder and complicated grief: 1‐year follow‐up efficacy data. Clin Psychol Psychother 2018; 26:204-217. [DOI: 10.1002/cpp.2342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Soledad Quero
- Departamento de Psicología Básica, Clínica y PsicobiologíaUniversitat Jaume I Castellón Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERON)Instituto Salud Carlos III Madrid Spain
| | - Mar Molés
- Departamento de Psicología Básica, Clínica y PsicobiologíaUniversitat Jaume I Castellón Spain
| | - Daniel Campos
- Departamento de Psicología Básica, Clínica y PsicobiologíaUniversitat Jaume I Castellón Spain
| | - Sabrina Andreu‐Mateu
- Departamento de Psicología Básica, Clínica y PsicobiologíaUniversitat Jaume I Castellón Spain
| | - Rosa M. Baños
- Departamento de Personalidad, Evaluación y Tratamientos PsicológicosUniversidad de Valencia Valencia Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERON)Instituto Salud Carlos III Madrid Spain
| | - Cristina Botella
- Departamento de Psicología Básica, Clínica y PsicobiologíaUniversitat Jaume I Castellón Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERON)Instituto Salud Carlos III Madrid Spain
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Abstract
OBJECTIVES This narrative review article provides an overview of current psychotherapeutic approaches specific for adjustment disorders (ADs) and outlines future directions for theoretically-based treatments for this common mental disorder within a framework of stepped care. METHODS Studies on psychological interventions for ADs were retrieved by using an electronic database search within PubMed and PsycINFO, as well as by scanning the reference lists of relevant articles and previous reviews. RESULTS The evidence base for psychotherapies specifically targeting the symptoms of AD is currently rather weak, but is evolving given several ongoing trials. Psychological interventions range from self-help approaches, relaxation techniques, e-mental-health interventions, behavioural activation to talking therapies such as psychodynamic and cognitive behavioural therapy. CONCLUSIONS The innovations in DSM-5 and upcoming ICD-11, conceptualising AD as a stress-response syndrome, will hopefully stimulate more research in regard to specific psychotherapeutic interventions for AD. Low intensive psychological interventions such as e-mental-health interventions for ADs may be a promising approach to address the high mental health care needs associated with AD and the limited mental health care resources in most countries around the world.
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Affiliation(s)
- Matthias Domhardt
- a Department of Clinical Psychology and Psychotherapy , University of Ulm , Ulm , Germany.,b Department of Child and Adolescent Psychiatry/Psychotherapy , University of Ulm , Ulm , Germany
| | - Harald Baumeister
- a Department of Clinical Psychology and Psychotherapy , University of Ulm , Ulm , Germany
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46
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Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112424. [PMID: 30384498 PMCID: PMC6266920 DOI: 10.3390/ijerph15112424] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/17/2018] [Accepted: 10/27/2018] [Indexed: 11/20/2022]
Abstract
Background: People on long-term sick leave often have a long-lasting process back to work, where the individuals may be in multiple and recurrent states; i.e., receiving different social security benefits or working, and over time they may shift between these states. The purpose of this study was to evaluate the effects of two vocational rehabilitation programs, compared to a control, on return-to-work (RTW) or increased employability in patients on long-term sick leave due to mental illness and/or chronic pain. Methods: In this randomized controlled study, 427 women and men were allocated to either (1) multidisciplinary team management, i.e., multidisciplinary assessments and individual rehabilitation management, (2) acceptance and commitment therapy (ACT), or (3) control. A positive outcome was defined as RTW or increased employability. The outcome was considered negative if the (part-time) wage was reduced or ceased, or if there was an indication of decreased employability. The outcome was measured one year after entry in the project and analyzed using binary and multinomial logistic regressions. Results: Participants in the multidisciplinary team group reported having RTW odds ratio (OR) 3.31 (95% CI 1.39–7.87) compared to the control group in adjusted models. Participants in the ACT group reported having increased employability OR 3.22 (95% CI 1.13–9.15) compared to the control group in adjusted models. Conclusions: This study of vocational rehabilitation in mainly female patients on long-term sick leave due to mental illness and/or chronic pain suggests that multidisciplinary team assessments and individually adapted rehabilitation interventions increased RTW and employability. Solely receiving the ACT intervention also increased employability.
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47
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Marco JH, Alonso S, Andani J. Early intervention with cognitive behavioral therapy reduces sick leave duration in people with adjustment, anxiety and depressive disorders. J Ment Health 2018; 29:247-255. [PMID: 30322314 DOI: 10.1080/09638237.2018.1521937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Early intervention in workers diagnosed with mental disorders is associated with a lower incidence of relapse and shorter sick leave. However, no studies have been carried out on the effect of early intervention using an evidence-based therapy, Cognitive Behavioral Therapy (CBT), on people with sick leave.Aims: The objectives of the present study are to study whether the type of intervention (early or late) will affect the total duration of the sick leave, the partial duration of the sick leave, the duration of the psychotherapy and the time until return to work after the psychotherapy ends. The sample was composed of 167 participants who were on sick leave for adjustment disorders, anxiety disorders or depressive disorder.Results: The participants who had early intervention with CBT had a significantly shorter duration of total sick leave and partial sick leave, and a shorter time until returning to work after the psychotherapy ended than those who had late intervention. There were no statistically differences in the duration or efficacy of the psychotherapy.Conclusion: We can suggest that providing early access to CBT significantly reduces the length of sick leave in patients with mental disorders.
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Affiliation(s)
- José H Marco
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Sandra Alonso
- Doctoral School of Catholic University of Valencia, Saint Vincent Martyr, Valencia, Spain.,Cathedra UMIVALE Innovation and Research in Pathology Work, Valencia, Spain
| | - Joaquín Andani
- Cathedra UMIVALE Innovation and Research in Pathology Work, Valencia, Spain.,Catholic University of Valencia, Saint Vincent Martyr, Valencia, Spain
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48
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Kojimahara N, Fukumoto M, Yoshikawa E, Shinada K, Tsuiki H. [Development process of Evidence-based "Return-to-work Guidance in Occupational Health 2017"]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2018; 60:103-111. [PMID: 29877207 DOI: 10.1539/sangyoeisei.2017-030-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE "Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017." MATERIALS AND METHODS The guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources. RESULTS Based on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6. DISCUSSION AND CONCLUSION From the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.
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Affiliation(s)
- Noriko Kojimahara
- Tokyo Women's Medical University.,Committee of Developing RTW Guidance in Occupational Health, the Japan Society for Occupational, Kanto Branch
| | - Masakatsu Fukumoto
- Social Welfare Corporation Nagaoka Welfare Society Metropolitan Division Health Care Facility for Elderly Shimbashi-Bara-no-sono.,Committee of Developing RTW Guidance in Occupational Health, the Japan Society for Occupational, Kanto Branch
| | - Etsuko Yoshikawa
- Japan Red Cross College of Nursing.,Committee of Developing RTW Guidance in Occupational Health, the Japan Society for Occupational, Kanto Branch
| | - Kayoko Shinada
- Tokyo Medical and Dental University.,Committee of Developing RTW Guidance in Occupational Health, the Japan Society for Occupational, Kanto Branch
| | - Hirokazu Tsuiki
- a-ru Limited Liability Company.,Committee of Developing RTW Guidance in Occupational Health, the Japan Society for Occupational, Kanto Branch
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Prevalence of Adjustment Problem and Its Predictors among First-Year Undergraduate Students in Ethiopian University: A Cross-Sectional Institution Based Study. PSYCHIATRY JOURNAL 2018; 2018:5919743. [PMID: 30356355 PMCID: PMC6176292 DOI: 10.1155/2018/5919743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/06/2018] [Indexed: 11/23/2022]
Abstract
Background Being in a university for the first time is an unpleasant event and time of heavy pressure relating to social things and dissatisfaction for several new faculty students. Adjustment difficulties are the foremost common issues among freshman students; World Health Organization area unit researched a full-of-life adjustment innovation in universities. Despite this reality, there is a few literature that identifies prevalence and factors related to the adjustment downside among university/college students. Methods Institutional based quantitative cross-sectional study style was conducted from May to June 2016. A total of 537 haphazardly elite students concerned within the study. The result adjustment downside was explained with Student Adjustment to College Questionnaire (SACQ). Data was described using descriptive analysis; logistic regression was used to assess the relation between adjustment downside and associated factors. An odds quantitative relation 95% confidence interval was used to point out the strength of association. Applied mathematics significance was declared as a p value less than 0.05. Result A total of 537 respondents participate with a response rate of eighty-five percent. the prevalence of adjustment downside among the respondents was 228 ( 42.5%). Of the respondents, 327 (60.9%) were male and therefore the mean (sd) age was 19 (+- 1) years. Being away from home and homesickness (AOR=4.15,95% CI: 2.46,2,99 and AOR=5. 9,95% CI: 2.35,14.76) and difficulties in socializing or making friends (AOR=3.99,95% CI:2.29,6.98) and difficulties in managing time and study skill (AOR=3.02,95% CI: 1.3,7.02) were abundant associated factors with adjustment downside. Conclusion The study confirms that freshman students joining university do face problems in adjusting themselves at the university. Homesickness, difficulties in socializing or making friends, and difficulties in managing time and study skill were found to be significant factors in adjustment downside.
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50
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Salomonsson S, Hedman-Lagerlöf E, Öst LG. Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders. Psychol Med 2018; 48:1954-1965. [PMID: 29380722 DOI: 10.1017/s0033291718000065] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.
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Affiliation(s)
- Sigrid Salomonsson
- Department of Clinical Neuroscience,Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - Erik Hedman-Lagerlöf
- Department of Clinical Neuroscience,Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - Lars-Göran Öst
- Department of Psychology,Stockholm University,Stockholm,Sweden
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