Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
Occup Environ Med. 2018 Sep;75(9):675-686. doi: 10.1136/oemed-2018-105073. Epub 2018 Jun 28.
Mental disorders are associated with significant functional impairment, sickness absence and disability. The consequences of sickness absence warrant investigation into interventions aimed at enhancing return to work (RTW) for workers with mental disorders. The present systematic review and meta-analysis aim to synthesise evidence on the effectiveness of interventions aimed at enhancing RTW in sick-listed workers with mental disorders.
EconLit, Embase, PsychInfo, PubMed, Svemed+ and Web of Science were searched for peer-reviewed, randomised or controlled studies assessing employment-related outcomes of interventions. A meta-analysis was conducted and meta-regressions were performed to explore prespecified potential sources of heterogeneity between studies.
The literature search yielded 3777 publications of which 42 (n=38 938) were included in the systematic review and 32 (n=9459) had appropriate data for the meta-analysis. The pooled effect size (95 % CI) was 0.14 (0.07 to 0.22). Meta-regressions revealed that the heterogeneity could not be attributed to study quality, timing of the intervention or length of the intervention. However, it could be partly explained by number of components included in the intervention, if the intervention included contact to the work place and by the disorder targeted by the intervention.
The results reveal strong evidence for interventions including contact to the work place and multicomponent interventions and moderate evidence for interventions including graded RTW. In addition, the results provide strong evidence for interventions targeting stress compared with interventions targeting other mental disorders. The findings point to important implications for policy and design of future interventions.
精神障碍与显著的功能障碍、病假和残疾有关。病假的后果需要调查旨在促进精神障碍患者重返工作岗位（RTW）的干预措施。本系统评价和荟萃分析旨在综合旨在促进精神障碍病假员工 RTW 的干预措施的有效性证据。
EconLit、Embase、PsychInfo、PubMed、Svemed+和 Web of Science 搜索了评估干预措施对就业相关结果的同行评审、随机或对照研究。进行了荟萃分析，并进行了荟萃回归分析，以探索研究之间预先指定的潜在异质性来源。
文献检索产生了 3777 篇出版物，其中 42 篇（n=38938）被纳入系统评价，32 篇（n=9459）有适当的数据进行荟萃分析。汇总效应大小（95%CI）为 0.14（0.07 至 0.22）。荟萃回归表明，异质性不能归因于研究质量、干预时间或干预时间长短。然而，如果干预措施包括与工作场所的联系以及干预措施针对的疾病，它可以部分解释为干预措施中包含的组件数量。
结果表明，包括与工作场所联系和多组件干预的干预措施具有强有力的证据，而包括分级 RTW 的干预措施则具有中等强度的证据。此外，结果为针对压力的干预措施提供了强有力的证据，而针对其他精神障碍的干预措施则提供了强有力的证据。这些发现为未来干预措施的政策和设计提供了重要启示。
