Predictors of return to work among patients in treatment for common mental disorders: a pre-post study.

backgroundEffects of return to work (RTW) interventions vary, and more knowledge is needed about the factors that contribute to RTW. This study investigated changes in work participation and mental health, and predictors of RTW among patients being treated for common mental disorders (CMDs).

methodsThe study was a prospective pre-post study of 164 patients treated at an RTW outpatient clinic for CMDs. Differences between before and after treatment were analysed using paired t tests for continuous variables and marginal homogeneity test for categorical variables. Univariable and multivariable logistic regression analyses were used to identify factors associated with RTW. Baseline data (patient characteristics, clinical status, generalized self-efficacy, expectations of future work ability) and treatment variables were used as independent variables in logistic regressions. Further analysis investigated whether improvements in symptoms, work ability, expectations of future work ability and generalized self-efficacy were associated with RTW.

resultsNumber of individuals with full work participation increased, and there were improvements in symptoms, work ability and generalized self-efficacy. In the final model for predicting RTW, baseline work ability and expectancy of future work ability, a history of psychiatric treatment and focus on RTW in the treatment predicted RTW. Improvement in expectations of future work ability at post-treatment did also predict RTW.

conclusionsAssessing work ability and expectations of RTW at the beginning of treatment is recommended to identify patients at risk of long-term sick leave. Individuals with a history of psychiatric treatment are also risking long-term work disability. It is essential that treatment focus not only on symptom-relief, but also on improving work ability and expectations of RTW. An RTW-focused approach in therapy is associated with RTW. TRAIL REGISTRATION: ClinicalTrails.gov ID NCT01181635 . Registered 08/12/2010.