Bond Charlotte Brøgger, Willert Morten Vejs, Ditlevsen Daniel Navy, Sandal Louise Fleng, Brandt Lars
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Aarhus, Denmark.
J Occup Rehabil. 2025 Jun 25. doi: 10.1007/s10926-025-10306-2.
The literature provides contradictory information on the effect of cognitive behavioural therapy (CBT) interventions on return to work (RTW) for patients on sick leave due to work-related stress.
We compared the cumulative number of sick leave weeks between a cohort of patients who received a CBT-based stress management intervention in the period 2011-2018 (N = 331) and a cohort of patients from 2010 to 2011 (N = 221) who did not receive the intervention. We also compared time until sustainable RTW (3 consecutive months of no sick registrations) between the cohorts.
Registry data on sickness absence were obtained from the national DREAM register (Danish Public Transfer Payments Database). The cumulative time of registered sick leave in DREAM until first sustainable period of RTW was visualized using Kaplan-Meier plots. A Cox proportional hazard model was used to compare the effectiveness of the intervention relative to the comparison cohort and was reported as hazard rate ratio.
The intervention cohort's cumulated number of weeks in DREAM across the total period from 0 to 36 months (median 29 range 26-32) was lower than that of the comparison cohort (median 40 range 34-52), (P = 0.005), corresponding to a 14% (95% CI 0.04-0.24) reduction. For RTW, a hazard ratio rate of 1.25 (95% CI 1.02-1.54) favouring the intervention group was found (P = 0.034).
The CBT stress management intervention significantly reduced the amount of sick leave and reduced the time until sustainable RTW for the intervention cohort compared to the comparison cohort.
关于认知行为疗法（CBT）干预措施对因工作相关压力而休病假的患者重返工作岗位（RTW）的影响，文献提供了相互矛盾的信息。
我们比较了在2011 - 2018年期间接受基于CBT的压力管理干预的一组患者（N = 331）与2010年至2011年未接受该干预的一组患者（N = 221）之间的病假累计周数。我们还比较了两组患者直至可持续重返工作岗位（连续3个月无病假记录）的时间。
从国家DREAM登记册（丹麦公共转移支付数据库）获取病假缺勤的登记数据。使用Kaplan - Meier图直观展示DREAM中登记病假直至首次可持续重返工作岗位的累计时间。采用Cox比例风险模型比较干预组与对照组的干预效果，并以风险率比报告。
干预组在DREAM中从0到36个月的累计周数（中位数29，范围26 - 32）低于对照组（中位数40，范围34 - 52），（P = 0.005），相当于减少了14%（95%CI 0.04 - 0.24）。对于重返工作岗位，发现有利于干预组的风险比率为1.25（95%CI 1.02 - 1.54）（P = 0.034）。
与对照组相比，CBT压力管理干预显著减少了干预组的病假天数，并缩短了直至可持续重返工作岗位的时间。
