Sick leave and return to work for patients with anxiety and depression: a longitudinal study of trajectories before, during and after work-focused treatment

Sandin, Kenneth; Anyan, Frederick; Osnes, Kåre; Gjengedal, Ragne G. H.; Leversen, Jonas S. R.; Rème, Silje Endresen; Hjemdal, Odin

doi:10.1136/bmjopen-2020-046336

Cited by 8 publications

(6 citation statements)

References 27 publications

(31 reference statements)

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“…If resilience aids adjustment, it is presumed that the higher the resilience, the more likely the patient is to continue working. In fact, there are reports that the higher the resilience after receiving work‐focused treatment, the lower the risk of sick leave 28 . However, in the present study, there was no difference in initial resilience capacity and the course of employment (continued work group vs. leaving work group).…”

Section: Discussioncontrasting

confidence: 76%

Effects of treatment contents on changes in resilience among workers with mood or anxiety disorders: A 3‐month longitudinal study

et al. 2023

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Aim:The aim of this study was to identify factors that influence changes in resilience among workers with mental health disorders, leading to effective treatment and support.Methods: Among the new patients at an institution, 81 who were working and had the ICD-10 diagnoses F3 and F4 were included. Resilience was measured at the initial visit and 3 months later using the S-H resilience test. Univariate and multiple regression analyses were conducted using the change in resilience between the two measurements as the objective variable, and treatment and attendance at work as explanatory variables.Results: There were no significant differences in resilience abilities between pre-and postmeasurement for the subjects as a whole. However, tests for the subgroups of diagnostic category, attendance at work, and treatment showed that resilience improved significantly in the mood disorder group, the leaving employment group, and the group receiving additional treatment. The results of the multiple regression analysis showed that treatment type (with or without additional treatment) had an effect on the degree of change in resilience, and among these "inpatient treatment" and "re-work program" were suggested to have an effect. Conclusion:The resilience of workers with mental health disorders was found to improve even after only 3 months of treatment, depending on the content of the treatment. We believe the significance of this study is the quantitative indication of the transition of resilience, which has not been made concrete until now.

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Section: Discussioncontrasting

confidence: 76%

Effects of treatment contents on changes in resilience among workers with mood or anxiety disorders: A 3‐month longitudinal study

et al. 2023

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“…Patients are referred by their general practitioners for treatment of depression and anxiety. Patients at the clinic are generally of working age, and previous research has shown that on average, half the patients are on sick leave due to depression or anxiety at baseline [ 22 ]. They are then screened by a clinical psychologist using anamnestic information, the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), and the MINI-International Neuropsychiatric Interview [ 23 – 25 ].…”

Section: Methodsmentioning

confidence: 99%

“…Data [22]. They are then screened by a clinical psychologist using anamnestic information, the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), and the MINI-International Neuropsychiatric Interview [23][24][25].…”

Section: Study Contextmentioning

confidence: 99%

Responsiveness to change in health status of the EQ-5D in patients treated for depression and anxiety

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Gjengedal

et al. 2023

Health Qual Life Outcomes

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Background The EQ-5D is a commonly used generic measure of health but evidence on its responsiveness to change in mental health is limited. This study aimed to explore the responsiveness of the five-level version of the instrument, the EQ-5D-5 L, in patients receiving treatment for depression and anxiety. Methods Patient data (N = 416) were collected at baseline and at end of treatment in an observational study in a Norwegian outpatient clinic. Patients were adults of working age (18–69 years) and received protocol-based metacognitive or cognitive therapy for depression or anxiety according to diagnosis. Responsiveness in the EQ-5D was compared to change in the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Effect sizes (Cohen’s d), Standardised response mean (SRM), and Pearson’s correlation were calculated. Patients were classified as “Recovered”, “Improved”, or “Unchanged” during treatment using the BDI-II and the BAI. ROC analyses determined whether the EQ-5D could correctly classify patient outcomes. Results Effect sizes were large for the BAI, the BDI-II, the EQ-5D value and the EQ VAS, ranging from d = 1.07 to d = 1.84. SRM were also large (0.93-1.67). Pearson’s correlation showed strong agreement between change scores of the EQ-5D value and the BDI-II (rs -0.54) and moderate between the EQ-5D value and the BAI (rs -0.43). The EQ-5D consistently identified “Recovered” patients versus “Improved” or “Unchanged” in the ROC analyses with AUROC ranging from 0.72 to 0.84. Conclusion The EQ-5D showed good agreement with self-reported symptom change in depression and anxiety, and correctly identified recovered patients. These findings indicate that the EQ-5D may be appropriately responsive to change in patients with depression and anxiety disorders, although replication in other clinical samples is needed.

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“…Furthermore, different types of work interventions such as individual placement and support have been found useful to aid RTW for people suffering from more severe mental health illness and in need of more supported employment [35,36]. Patients that RTW later could also be struggling with other unresolved issues either at work or at home [37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Work after mental-health-related absence: a qualitative study of perceived change after a combination of metacognitive therapy and work-focused interventions

et al. 2022

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Background Sick leave caused by common mental health disorders (CMD) is becoming more prevalent. For most people, work is essential for good mental and physical health. It is necessary to provide treatments that facilitate return to work (RTW) and a reduction of symptoms. A qualitative study can contribute to an understanding of what makes an intervention successful. The aim of this study was to investigate how individuals who are on sick leave because of CMD perceive and handle their symptoms and their work, after completing metacognitive therapy and work-focused interventions. Methods Semi-structured interviews were conducted with 23 participants after they had completed therapy. Thematic analysis was used to analyse the data. Results Through both therapy and the process of RTW, the participants had gained increased awareness and understanding of their mental health problems and the relationship between those problems and work. Together with the sense that they were in charge of their own process of RTW, this helped to improve their self-confidence. An important part of the process was the change to new strategies and the rejection of older maladaptive ones, in relation to both mental health and work. Being open about their mental illness in the workplace could lead to support but also to the opposite, and therefore not an option for everyone. After treatment, most had returned to work and gained a more positive outlook on the future, but some had less confidence in their ability to deal with future symptoms and workplace issues. Conclusions Achieving improved self-confidence and adopting new strategies, which enabled them to change how they related to their mental problems and how they addressed their problems at work, seemed to have increased their self-efficacy. Active involvement in therapy and at work was also important, both for the process and as a way of increasing self-efficacy. This gave them renewed belief in themselves and in their ability to handle their work at present and in the future. Despite this being a manualized treatment, the participants’ experience was that it was adapted to each individual, something they regarded as important.

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Sick leave and return to work for patients with anxiety and depression: a longitudinal study of trajectories before, during and after work-focused treatment

Cited by 8 publications

References 27 publications

Effects of treatment contents on changes in resilience among workers with mood or anxiety disorders: A 3‐month longitudinal study

Effects of treatment contents on changes in resilience among workers with mood or anxiety disorders: A 3‐month longitudinal study

Responsiveness to change in health status of the EQ-5D in patients treated for depression and anxiety

Work after mental-health-related absence: a qualitative study of perceived change after a combination of metacognitive therapy and work-focused interventions

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