Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression : two subgroup analyses
(2018) In Occupational and environmental medicine 75(1). p.52-58- Abstract
OBJECTIVES: Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745).
METHODS: After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on... (More)
OBJECTIVES: Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745).
METHODS: After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months.
RESULTS: For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found.
CONCLUSIONS: No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored.
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- author
- Kaldo, Viktor ; Lundin, Andreas ; Hallgren, Mats ; Kraepelien, Martin ; Strid, Catharina LU ; Ekblom, Örjan ; Lavebratt, Catharina ; Lindefors, Nils ; Öjehagen, Agneta LU and Forsell, Yvonne
- organization
- publishing date
- 2018
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cognitive behavioral therapy, depression, internet therapy, physical exercise, return to work
- in
- Occupational and environmental medicine
- volume
- 75
- issue
- 1
- pages
- 7 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85039064044
- pmid:28951431
- ISSN
- 1470-7926
- DOI
- 10.1136/oemed-2017-104326
- language
- English
- LU publication?
- yes
- id
- d74b8dc7-16f4-41ee-9232-5448edb704d9
- date added to LUP
- 2018-01-24 14:24:51
- date last changed
- 2023-11-17 13:00:37
@article{d74b8dc7-16f4-41ee-9232-5448edb704d9,
abstract = {{<p>OBJECTIVES: Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745).</p><p>METHODS: After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months.</p><p>RESULTS: For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found.</p><p>CONCLUSIONS: No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored.</p>}},
author = {{Kaldo, Viktor and Lundin, Andreas and Hallgren, Mats and Kraepelien, Martin and Strid, Catharina and Ekblom, Örjan and Lavebratt, Catharina and Lindefors, Nils and Öjehagen, Agneta and Forsell, Yvonne}},
issn = {{1470-7926}},
keywords = {{cognitive behavioral therapy; depression; internet therapy; physical exercise; return to work}},
language = {{eng}},
number = {{1}},
pages = {{52--58}},
publisher = {{BMJ Publishing Group}},
series = {{Occupational and environmental medicine}},
title = {{Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression : two subgroup analyses}},
url = {{http://dx.doi.org/10.1136/oemed-2017-104326}},
doi = {{10.1136/oemed-2017-104326}},
volume = {{75}},
year = {{2018}},
}