Psychoeducation to facilitate return to work in individuals on sick leave and at risk of having a mental disorder: protocol of a randomised controlled trial

Pernille Pedersen, Hans Jørgen Søgaard, Bjarne Frostholm Yde, Merete Labriola, Ellen A Nohr, Chris Jensen, Pernille Pedersen, Hans Jørgen Søgaard, Bjarne Frostholm Yde, Merete Labriola, Ellen A Nohr, Chris Jensen

Abstract

Background: Sickness absence due to poor mental health is a common problem in many Western countries. To facilitate return to work, it may be important to identify individuals on sick leave and at risk of having a mental disorder and subsequently to offer appropriate treatment. Psychoeducation alone has not previously been used as a return to work intervention, but may be a promising tool to facilitate return to work. Therefore, the aim of the study is to evaluate the effectiveness of psychoeducation designed specifically to facilitate return to work for individuals on sick leave and at risk of having a mental disorder. The psychoeducation was a supplement to the various standard offers provided by the job centres.

Methods/design: The study is a randomised controlled trial, in which individuals on sick leave either receive psychoeducation and standard case management or standard case management alone. Participants were individuals with mental health symptoms, who had been on sick leave from part-time or full-time work or unemployment for about 4-8 weeks. The psychoeducational intervention was group-based and the course consisted of 2 hour sessions once a week for 6 weeks. The course was given by psychiatric nurses, a psychologist, a social worker, a physiotherapist and a person who had previously been on sick leave due to mental health problems. The sessions focused on stress and work life, and the purpose was to provide individuals on sick leave the skills to understand and improve their mental functioning.The primary outcome is the duration of sickness absence measured by register data. Secondary outcomes include psychological symptoms, mental health-related quality of life, and locus of control. These outcomes are measured by questionnaires at the start of the intervention and at 3 and 6 months follow-up.

Discussion: On the basis of this trial, the effect of psychoeducation for individuals on sick leave and at risk of having a mental disorder will be studied. The results will contribute to the continuing research on sickness absence and mental health. It will primarily show whether psychoeducation can lead to faster and sustainable return to work.

Trial registration: Clinical Trial.gov NCT01637363. Registered 6 July 2012.

Figures

Figure 1
Figure 1
Flowchart of the study.

References

    1. Henderson M, Harvey SB, Overland S, Mykletun A, Hotopf M. Work and common psychiatric disorders. J R Soc Med. 2011;104(5):198–207. doi: 10.1258/jrsm.2011.100231.
    1. Arends I, Bruinvels DJ, Rebergen DS, Nieuwenhuijsen K, Madan I, Neumeyer-Gromen A, Bultmann U, Verbeek JH. Cochrane Database Syst Rev. 2012. Interventions to facilitate return to work in adults with adjustment disorders.
    1. Lidwall U. Disabil Rehabil. 2014. Sick leave diagnoses and return to work: a Swedish register study; pp. 1–15.
    1. Stenlund T, Ahlgren C, Lindahl B, Burell G, Steinholtz K, Edlund C, Nilsson L, Knutsson A, Birgander LS. Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST–a randomized clinical trial. Int J Behav Med. 2009;16(3):294–303. doi: 10.1007/s12529-008-9011-7.
    1. Sanderson K, Andrews G. Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatry. 2006;51(2):63–75.
    1. Rebergen DS, Bruinvels DJ, Bezemer PD, van der Beek AJ, van Mechelen W. Guideline-based care of common mental disorders by occupational physicians (CO-OP study): a randomized controlled trial. J Occup Environ Med. 2009;51(3):305–312. doi: 10.1097/JOM.0b013e3181990d32.
    1. Soegaard H. Variation in effect of intervention studies in research on sickness absence. Open Access J Clin Trials. 2012;4:1–20. doi: 10.2147/OAJCT.S25651.
    1. Nieuwenhuijsen K, Bultmann U, Neumeyer-Gromen A, Verhoeven AC, Verbeek JH, van der Feltz-Cornelis CM. Cochrane Database Syst Rev. 2008. Interventions to improve occupational health in depressed people.
    1. Borg V, Nexø MA, Kolte IV, Andersen MF. Hvidbog om mentalt helbred, sygefravær og tilbagevenden til arbejde [White paper on mental health, sickness absence and return to work]: Det Nationale Forskningscenter for Arbejdsmiljø. 2010.
    1. Wessely S, Bryant RA, Greenberg N, Earnshaw M, Sharpley J, Hughes JH. Does psychoeducation help prevent post traumatic psychological distress? Psychiatry. 2008;71(4):287–302.
    1. Donker T, Griffiths KM, Cuijpers P, Christensen H. Psychoeducation for depression, anxiety and psychological distress: a meta-analysis. BMC Med. 2009;7:79-7015-7-79. doi: 10.1186/1741-7015-7-79.
    1. Stafford N, Colom F. Purpose and effectiveness of psychoeducation in patients with bipolar disorder in a bipolar clinic setting. Acta Psychiatr Scand Suppl. 2013;127(442):11–8. doi: 10.1111/acps.12118.
    1. Casanas R, Catalan R, del Val JL, Real J, Valero S, Casas M. Effectiveness of a psycho-educational group program for major depression in primary care: a randomized controlled trial. BMC Psychiatry. 2012;12:230-244X-12-230. doi: 10.1186/1471-244X-12-230.
    1. Colom F. Keeping therapies simple: psychoeducation in the prevention of relapse in affective disorders. Br J Psychiatry. 2011;198(5):338–340. doi: 10.1192/bjp.bp.110.090209.
    1. Colom F, Vieta E, Martinez A, Jorquera A, Gasto C. What is the role of psychotherapy in the treatment of bipolar disorder? Psychother Psychosom. 1998;67(1):3–9. doi: 10.1159/000012252.
    1. Morokuma I, Shimodera S, Fujita H, Hashizume H, Kamimura N, Kawamura A, Nishida A, Furukawa TA, Inoue S. Psychoeducation for major depressive disorders: A randomised controlled trial. Psychiatry Res. 2013;210:134–139. doi: 10.1016/j.psychres.2013.05.018.
    1. Dalgard OS. A randomized controlled trial of a psychoeducational group program for unipolar depression in adults in Norway (NCT00319540) Clin Pract Epidemiol Ment Health. 2006;2:15. doi: 10.1186/1745-0179-2-15.
    1. Hansson M, Bodlund O, Chotai J. Patient education and group counselling to improve the treatment of depression in primary care: a randomized controlled trial. J Affect Disord. 2008;105(1–3):235–240. doi: 10.1016/j.jad.2007.04.007.
    1. Allart-van Dam E, Hosman CM, Hoogduin CA, Schaap CP. Prevention of depression in subclinically depressed adults: follow-up effects on the 'Coping with Depression' course. J Affect Disord. 2007;97(1–3):219–228. doi: 10.1016/j.jad.2006.06.020.
    1. Parikh SV, Zaretsky A, Beaulieu S, Yatham LN, Young LT, Patelis-Siotis I, Macqueen GM, Levitt A, Arenovich T, Cervantes P, Velyvis V, Kennedy SH, Streiner DL. A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: a Canadian Network for Mood and Anxiety treatments (CANMAT) study [CME. J Clin Psychiatry. 2012;73(6):803–810. doi: 10.4088/JCP.11m07343.
    1. Sajatovic M, Davies MA, Ganocy SJ, Bauer MS, Cassidy KA, Hays RW, Safavi R, Blow FC, Calabrese JR. A comparison of the life goals program and treatment as usual for individuals with bipolar disorder. Psychiatr Serv. 2009;60(9):1182–1189. doi: 10.1176/ps.2009.60.9.1182.
    1. D'Souza R, Piskulic D, Sundram S. A brief dyadic group based psychoeducation program improves relapse rates in recently remitted bipolar disorder: a pilot randomised controlled trial. J Affect Disord. 2010;120(1–3):272–276. doi: 10.1016/j.jad.2009.03.018.
    1. Colom F, Vieta E, Sanchez-Moreno J, Palomino-Otiniano R, Reinares M, Goikolea JM, Benabarre A, Martinez-Aran A. Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. Br J Psychiatry. 2009;194(3):260–265. doi: 10.1192/bjp.bp.107.040485.
    1. Brown JS, Elliott SA, Boardman J, Ferns J, Morrison J. Meeting the unmet need for depression services with psycho-educational self-confidence workshops: preliminary report. Br J Psychiatry. 2004;185:511–515. doi: 10.1192/bjp.185.6.511.
    1. Rouget BW, Aubry JM. Efficacy of psychoeducational approaches on bipolar disorders: a review of the literature. J Affect Disord. 2007;98(1–2):11–27. doi: 10.1016/j.jad.2006.07.016.
    1. Allart-van Dam E, Hosman CMH, Hoogduin CAL, Schaap CPDR. The coping with depression course: Short-term outcomes and mediating effects of a randomized controlled trial in the treatment of subclinical depression. Behav Ther. 2003;34(3):381–396. doi: 10.1016/S0005-7894(03)80007-2.
    1. Bakker IM, Terluin B, van Marwijk HW, van der Windt DA, Rijmen F, van Mechelen W, Stalman WA. A cluster-randomised trial evaluating an intervention for patients with stress-related mental disorders and sick leave in primary care. PLoS Clin Trials. 2007;2(6):e26. doi: 10.1371/journal.pctr.0020026.
    1. de Vente W, Kamphuis JH, Emmelkamp PM, Blonk RW. Individual and group cognitive-behavioral treatment for work-related stress complaints and sickness absence: a randomized controlled trial. J Occup Health Psychol. 2008;13(3):214–231. doi: 10.1037/1076-8998.13.3.214.
    1. Grossi G, Santell B. Quasi-experimental evaluation of a stress management programme for female county and municipal employees on long-term sick leave due to work-related psychological complaints. J Rehabil Med. 2009;41(8):632–638. doi: 10.2340/16501977-0379.
    1. Eriksen HR, Ihlebaek C, Mikkelsen A, Gronningsaeter H, Sandal GM, Ursin H. Improving subjective health at the worksite: a randomized controlled trial of stress management training, physical exercise and an integrated health programme. Occup Med (Lond) 2002;52(7):383–391. doi: 10.1093/occmed/52.7.383.
    1. Willert MV, Thulstrup AM, Hertz J. Changes in stress and coping from a randomized controlled trial of a three-month stress management intervention. Scand J Work Environ Health. 2009;35(2):145–152. doi: 10.5271/sjweh.1313.
    1. van der Klink JJ, Blonk RW, Schene AH, van Dijk FJ. Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design. Occup Environ Med. 2003;60(6):429–437. doi: 10.1136/oem.60.6.429.
    1. Nystuen P, Hagen KB. Solution-focused intervention for sick listed employees with psychological problems or muscle skeletal pain: a randomised controlled trial [ISRCTN39140363. BMC Public Health. 2006;6:69. doi: 10.1186/1471-2458-6-69.
    1. Bekendtgørelse af Lov om Sygedagpenge nr. 833 af 26/06/2012 Gældende. [The Danish sickness absence legislation no. 653 of 26/06/2012]. [] Accessed November/06, 2014
    1. Aust B, Helverskov T, Nielsen MB, Bjorner JB, Rugulies R, Nielsen K, Sorensen OH, Grundtvig G, Andersen MF, Hansen JV, Buchardt HL, Nielsen L, Lund TL, Andersen I, Andersen MH, Clausen AS, Heinesen E, Mortensen OS, Ektor-Andersen J, Orbaek P, Winzor G, Bultmann U, Poulsen OM. The Danish national return-to-work program–aims, content, and design of the process and effect evaluation. Scand J Work Environ Health. 2012;38(2):120–133. doi: 10.5271/sjweh.3272.
    1. Sogaard HJ, Bech P. Psychiatric disorders in long-term sickness absence – a population-based cross-sectional study. Scand J Public Health. 2009;37(7):682–689. doi: 10.1177/1403494809344357.
    1. Sogaard HJ, Bech P. Predictive validity of common mental disorders screening questionnaire as a screening instrument in long term sickness absence. Scand J Public Health. 2010;38(4):375–385. doi: 10.1177/1403494809350520.
    1. Det National Forksningscenter for Arbejdsmiljø . Det store TTA-projekt. Proces-, effekt-, og økonomisk evaluering. [The Dansih National Return to Work program. Evaluation on proces, effect and economy] 2012.
    1. Derogatis LR, Unger R. Corsini Encyclopedia Psychol. 2010. Symptom Checklist‒90‒Revised; pp. 1–2.
    1. Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selectionf. Med Care. 1992;30(6):473–483. doi: 10.1097/00005650-199206000-00002.
    1. Wallston BS, Wallston KA, Kaplan GD, Maides SA. Development and validation of the health locus of control (HLC) scale. J Consult Clin Psychol. 1976;44(4):580. doi: 10.1037/0022-006X.44.4.580.
    1. Derogatis LR. SCL-90-R. Symptom Checklist-90-R. Vejledning til administration og scoring [SCL-90-R. Symptom Checklist-90-R. Instructions for administration and scoring] 2009.
    1. Bjørner JB. Dansk manual til SF-36: et spørgeskema om helbredsstatus [Danish SF-36 manual: a questionnaire on health status] Copenhagen: Lægemiddelindustriforeningen; 1997.
    1. OECD . Mental health and work. Denmark: OECD Publishing; 2013.
    1. Zubin J, Spring B. Vulnerability–a new view of schizophrenia. J Abnorm Psychol. 1977;86(2):103–126. doi: 10.1037/0021-843X.86.2.103.
    1. Solomon P. Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatr Rehabil J. 2004;27(4):392–401. doi: 10.2975/27.2004.392.401.
    1. Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Cochrane Database Syst Rev. 2009. Exercise for depression.
    1. Ten Have M, de Graaf R, Monshouwer K. Physical exercise in adults and mental health status findings from the Netherlands mental health survey and incidence study (NEMESIS) J Psychosom Res. 2011;71(5):342–348. doi: 10.1016/j.jpsychores.2011.04.001.
    1. Klein JP, Logan B, Harhoff M, Andersen PK. Analyzing survival curves at a fixed point in time. Stat Med. 2007;26(24):4505–4519. doi: 10.1002/sim.2864.
    1. Parner ET, Andersen PK. Regression analysis of censored data using pseudo-observations. Stata J. 2010;10(3):408–422(15).
    1. Ten Have TR, Normand SL, Marcus SM, Brown CH, Lavori P, Duan N. Intent-to-Treat vs. Non-Intent-to-Treat Analyses under Treatment Non-Adherence in Mental Health Randomized Trials. Psychiatr Ann. 2008;38(12):772–783. doi: 10.3928/00485713-20081201-10.
    1. Sogaard HJ, Bech P. The effect of detecting undetected common mental disorders on psychological distress and quality of life in long-term sickness absence: a randomised controlled trial. Scand J Public Health. 2010;38(8):845–856. doi: 10.1177/1403494810379292.
    1. van Poppel MN, de Vet HC, Koes BW, Smid T, Bouter LM. Measuring sick leave: a comparison of self-reported data on sick leave and data from company records. Occup Med (Lond) 2002;52(8):485–490. doi: 10.1093/occmed/52.8.485.
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться