Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, Hellerup, 2900, Denmark.
The National Board of Social Services in Denmark, Edisonsvej 1, Odense, 5000, Denmark.
J Occup Rehabil. 2023 Sep;33(3):570-580. doi: 10.1007/s10926-023-10094-7. Epub 2023 Feb 27.
Integration of vocational rehabilitation and mental healthcare has shown some effect on work participation at 1-year follow-up after sick leave with depression and anxiety. We aimed to study the effect on work and health outcomes at 2-year follow-up, why we performed a randomized trial was conducted to study the effectiveness of integrated intervention (INT) compared to service as usual (SAU) and best practice mental healthcare (MHC). We included 631 participants, and at 24-month follow-up, we detected no differences in effect between INT and SAU. Compared to MHC, INT showed faster return-to-work (RTW) rates (p = 0.044) and a higher number of weeks in work (p = 0.024). No symptom differences were observed between the groups at 24 months. In conclusion, compared to SAU, INT was associated with a slightly higher work rate reaching borderline statistical significance at 12-month follow-up and lower stress levels at 6-month follow-up. The disappearance of relative effect between 12 and 24 months may be explained by the fact that the intervention lasted less than 12 months or by delayed spontaneous remission in the SAU group after 12 months. Despite the lack of effect at long-term follow-up, INT still performed slightly better than SAU overall. Moderate implementation difficulties, may partly explain the absence of the hypothesized effect. Integrated intervention, as implemented in this trial, showed some positive effects on mid-term vocational status and short-term stress symptom levels. However, these effects were not sustained beyond the duration of the intervention.
职业康复与精神卫生保健相结合在抑郁症和焦虑症病假后 1 年随访时对工作参与有一定效果。我们的目的是研究在 2 年随访时对工作和健康结果的影响，这就是为什么我们进行了一项随机试验，以研究综合干预（INT）与常规服务（SAU）和最佳实践精神保健（MHC）相比的有效性。我们纳入了 631 名参与者，在 24 个月随访时，我们没有检测到 INT 和 SAU 之间的效果差异。与 MHC 相比，INT 显示出更快的复工率（p=0.044）和更多的工作周数（p=0.024）。在 24 个月时，各组之间没有观察到症状差异。总之，与 SAU 相比，INT 与稍高的工作率相关，在 12 个月随访时达到边缘统计学意义，在 6 个月随访时压力水平较低。在 12 个月至 24 个月之间相对效果的消失可能是由于干预持续时间少于 12 个月或在 12 个月后 SAU 组的自发缓解延迟所致。尽管在长期随访中没有效果，但 INT 总体上仍略优于 SAU。中等的实施困难，可能部分解释了假设效果的缺失。本试验中实施的综合干预对中期职业状况和短期压力症状水平有一些积极影响。然而，这些效果并没有持续到干预结束后。
