Employees Receiving Inpatient Treatment for Common Mental Disorders in Germany: Factors Associated with Time to First and Full Return to Work.

The return-to-work outcomes were self-reported because no national-level sickness absence register data were available, so people's own reports may have influenced both the factors and the outcome. The separate analyses for psychiatric and rehabilitation settings were done after the main analysis, and the authors say they should be treated with caution because there were too few participants for reliable subgroup estimates. Work factors and some outcomes were recalled after the event, so recall bias may have affected the reported timing and workplace experiences. The sample was selected from employed people who intended to return to their current employer and had limited previous absence, so it may not represent people with longer absence, job loss, or different work goals. Seventeen participants dropped out after baseline and were on average younger, more often without a partner, more likely to smoke, and reported higher work-privacy conflict and depressive symptoms, so the analysed sample may differ from the original participants. The study did not assess the types of treatment people received, so differences between settings cannot be attributed to specific therapies. Because this was an observational cohort, the associations cannot show that any factor caused faster or slower return.

The study was funded by Bundesanstalt für Arbeitsschutz und Arbeitsmedizin. The supplied text does not include a separate conflict-of-interest declaration.

Do not conclude that medical rehabilitation itself caused faster return or that psychiatric treatment caused slower return. The two settings were not randomly assigned, and participants differed in diagnoses, prior absence, treatment format, and baseline health, so the study cannot separate the effect of the setting from those differences.