Predictors of Return to Work 6 Months After the End of Treatment in Patients with Common Mental Disorders: A Cohort Study.
Mattias Victor, Bjørn Lau, Torleif Ruud
PMID 29234955WHAT IT FOUND
In patients with common mental disorders, high occupational status and better self-rated work ability at end of treatment were linked to successful return to work at 6 months.
Work participation did not change over the follow-up. This does not show that treatment caused it.
Key findings
01At the 6-month follow-up, 73 patients (75%) were classified as having successful return to work.
02In the final model, high occupational status (OR 5.43, 95% CI 1.46–20.24) and higher work ability at the end of treatment (OR 1.36, 95% CI 1.09–1.70) were significant predictors of successful return to work.
03Between the end of treatment and the 6-month follow-up, work participation and self-reported symptoms did not change significantly, while self-assessed work ability increased by 0.74 points and generalized self-efficacy increased by 0.06 points.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only 106 of 561 patients who attended a first session completed all three questionnaires, and 165 eligible patients were never asked to participate, so the final sample may not represent all patients. The sample was mostly women and high-skilled white-collar workers, with 74% having college or higher university degrees, so findings may not apply to other groups. The study did not measure the working environment or any interventions during follow-up, so other workplace or treatment factors may explain the associations. The sample was small relative to the number of predictors, and some odds ratios had very wide confidence intervals, so the estimates are imprecise. Return to work was defined by combining patients returning after sick leave and patients maintaining work participation when at risk of sick leave, so different mechanisms may affect these groups. The study is observational, so it cannot show that treatment, occupational status, or work ability caused return to work.
The easy way to misread this
Do not conclude that a patient's job type can be changed by therapy to improve return to work. High occupational status was associated with successful return to work, but the study did not test job changes or workplace adjustments, and occupational status was recorded before treatment.