Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
J Affect Disord. 2019 Oct 1;257:263-270. doi: 10.1016/j.jad.2019.07.018. Epub 2019 Jul 5.
We investigated one-year trajectories of symptom recovery, work functioning and the return to work percentage (RTW%) among patients with common mental disorders (CMDs).
Data were used from a cluster-randomised controlled trial evaluating a problem-solving intervention for CMD patients (N = 158) who had returned to work. Information on anxiety and depressive symptoms, work functioning and RTW% was collected at baseline and 3, 6 and 12 months follow-up. Latent class growth analyses were used to identify trajectories for the four outcomes and investigate how these trajectories clustered in higher order latent classes. Additionally, we investigated the relation between patient characteristics and class membership.
We identified four trajectories for all four outcomes and derived three higher order latent classes: slow recovery (42% [66/158]) (high anxiety and depressive symptoms, moderate to low work functioning and fast RTW); fast recovery (25% [40/158]) (low anxiety and depressive symptoms, high work functioning and fast RTW); and gradual recovery (33% [52/158] (decreasing anxiety and depressive symptoms, increasing or low work functioning and fast RTW). Participants with a higher work engagement and readiness to stay at work were more likely to belong to the fast recovery class.
Due to the relatively small sample size, some trajectories consisted of few participants. Symptom severity was self-reported.
Many CMD patients experience high levels of mental health symptoms and work functioning problems during the year post RTW. Creating realistic recovery expectations (for both patients and their environments) could be important for successful and sustainable recovery and work participation.
我们研究了常见精神障碍(CMD)患者在回归工作后一年内症状恢复、工作功能和重返工作岗位比例(RTW%)的变化轨迹。
本研究数据来自一项针对已重返工作岗位的 CMD 患者(n=158)的问题解决干预的集群随机对照试验。在基线和 3、6 和 12 个月随访时收集焦虑和抑郁症状、工作功能和 RTW%的信息。使用潜在类别增长分析来识别四个结局的轨迹,并研究这些轨迹如何聚类成更高阶的潜在类别。此外,我们还调查了患者特征与类别归属之间的关系。
我们为所有四个结局确定了四个轨迹,并得出了三个更高阶的潜在类别:缓慢恢复(42% [66/158])(焦虑和抑郁症状高,工作功能中度至低,RTW 快);快速恢复(25% [40/158])(焦虑和抑郁症状低,工作功能高,RTW 快);和逐渐恢复(33% [52/158](焦虑和抑郁症状逐渐减轻,工作功能增加或降低,RTW 快)。工作投入度较高且有意愿继续工作的患者更有可能属于快速恢复类别。
由于样本量相对较小,一些轨迹的参与者较少。症状严重程度是自我报告的。
许多 CMD 患者在重返工作岗位后的一年内经历着较高水平的心理健康症状和工作功能问题。为成功和可持续的康复和工作参与创造现实的康复预期(对患者及其环境而言)可能很重要。