Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders
Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the fi...
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| Veröffentlicht in: | Psychological medicine 2018-09, Vol.48 (12), p.1954-1965 |
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| container_end_page | 1965 |
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| container_issue | 12 |
| container_start_page | 1954 |
| container_title | Psychological medicine |
| container_volume | 48 |
| creator | Salomonsson, Sigrid Hedman-Lagerlöf, Erik Öst, Lars-Göran |
| description | Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved. |
| doi_str_mv | 10.1017/S0033291718000065 |
| format | Article |
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The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.</description><identifier>ISSN: 0033-2917</identifier><identifier>ISSN: 1469-8978</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291718000065</identifier><identifier>PMID: 29380722</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>absenteeism ; Adjustment ; adjustment disorder ; Anxiety ; Bias ; CBT ; Clinical trials ; Cognitive ability ; Cognitive behavioral therapy ; common mental disorders ; depression ; Health services ; Humans ; Insomnia ; Integrated care ; Intervention ; Mental depression ; Mental disorders ; Mental Disorders - rehabilitation ; Meta-analysis ; Occupational health ; Outcome Assessment (Health Care) - statistics & numerical data ; Problem solving ; PST ; Psychiatric symptoms ; Psychology ; Psychotherapy ; Psychotherapy - statistics & numerical data ; psykologi ; Quality ; Return to Work ; review ; Sick Leave ; Symptoms ; Systematic review</subject><ispartof>Psychological medicine, 2018-09, Vol.48 (12), p.1954-1965</ispartof><rights>Copyright © Cambridge University Press 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-b68dc6c9eef0e0c42576e079495c42bf209376960a3eb9e2d38779fbd37a9e3e3</citedby><cites>FETCH-LOGICAL-c448t-b68dc6c9eef0e0c42576e079495c42bf209376960a3eb9e2d38779fbd37a9e3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0033291718000065/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,230,314,777,781,882,12827,27905,27906,30980,55609</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29380722$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-160990$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:138896952$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Salomonsson, Sigrid</creatorcontrib><creatorcontrib>Hedman-Lagerlöf, Erik</creatorcontrib><creatorcontrib>Öst, Lars-Göran</creatorcontrib><title>Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.</description><subject>absenteeism</subject><subject>Adjustment</subject><subject>adjustment disorder</subject><subject>Anxiety</subject><subject>Bias</subject><subject>CBT</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>common mental disorders</subject><subject>depression</subject><subject>Health services</subject><subject>Humans</subject><subject>Insomnia</subject><subject>Integrated care</subject><subject>Intervention</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental Disorders - rehabilitation</subject><subject>Meta-analysis</subject><subject>Occupational health</subject><subject>Outcome Assessment (Health Care) - statistics & numerical data</subject><subject>Problem solving</subject><subject>PST</subject><subject>Psychiatric symptoms</subject><subject>Psychology</subject><subject>Psychotherapy</subject><subject>Psychotherapy - statistics & numerical data</subject><subject>psykologi</subject><subject>Quality</subject><subject>Return to Work</subject><subject>review</subject><subject>Sick Leave</subject><subject>Symptoms</subject><subject>Systematic review</subject><issn>0033-2917</issn><issn>1469-8978</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1ks9u1DAQxiMEokvhAbggS1w4EDq2s3HMrSp_ilSphwJXy7Eni9skXjzJVvsWPDJedlskUH2xx_P7vrE8UxQvObzjwNXJFYCUQnPFG8irXj4qFryqddlo1TwuFrt0ucsfFc-IrgG45JV4WhwJLRtQQiyKX1fB3YxIxGxLODp8zyyjLU042Ck4lnAT8JbZ0bMBJ1va0fZbCsRix9a0dT9iH1fB2Z5NCe004DgR62JiYfRhE_xs-8yOjHIZ1qPdIPMzsikyF4chJ3aKrPaBYvKY6HnxpMsafHHYj4tvnz5-PTsvLy4_fzk7vShdVTVT2daNd7XTiB0guEosVY2gdKWXOWg7AVqqWtdgJbYahZeNUrprvVRWo0R5XJR7X7rF9dyadQqDTVsTbTCHq5t8QlNp0NBk_u2D_Ifw_dTEtDI0G16D1pDxN3t8neLPGWkyQyCHfW9HjDMZrrXMHVNSZvT1P-h1nFP-ZzICGgEC6j8U31MuRaKE3f0LOJjdNJj_piFrXh2c53ZAf6-4a38G5MHUDm0KfoV_az9s-xuWHMFY</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Salomonsson, Sigrid</creator><creator>Hedman-Lagerlöf, Erik</creator><creator>Öst, Lars-Göran</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7QP</scope><scope>7QR</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DG7</scope></search><sort><creationdate>20180901</creationdate><title>Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders</title><author>Salomonsson, Sigrid ; Hedman-Lagerlöf, Erik ; Öst, Lars-Göran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-b68dc6c9eef0e0c42576e079495c42bf209376960a3eb9e2d38779fbd37a9e3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>absenteeism</topic><topic>Adjustment</topic><topic>adjustment disorder</topic><topic>Anxiety</topic><topic>Bias</topic><topic>CBT</topic><topic>Clinical trials</topic><topic>Cognitive ability</topic><topic>Cognitive behavioral therapy</topic><topic>common mental disorders</topic><topic>depression</topic><topic>Health services</topic><topic>Humans</topic><topic>Insomnia</topic><topic>Integrated care</topic><topic>Intervention</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental Disorders - rehabilitation</topic><topic>Meta-analysis</topic><topic>Occupational health</topic><topic>Outcome Assessment (Health Care) - statistics & numerical data</topic><topic>Problem solving</topic><topic>PST</topic><topic>Psychiatric symptoms</topic><topic>Psychology</topic><topic>Psychotherapy</topic><topic>Psychotherapy - statistics & numerical data</topic><topic>psykologi</topic><topic>Quality</topic><topic>Return to Work</topic><topic>review</topic><topic>Sick Leave</topic><topic>Symptoms</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salomonsson, Sigrid</creatorcontrib><creatorcontrib>Hedman-Lagerlöf, Erik</creatorcontrib><creatorcontrib>Öst, Lars-Göran</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Stockholms universitet</collection><jtitle>Psychological medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salomonsson, Sigrid</au><au>Hedman-Lagerlöf, Erik</au><au>Öst, Lars-Göran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol. Med</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>48</volume><issue>12</issue><spage>1954</spage><epage>1965</epage><pages>1954-1965</pages><issn>0033-2917</issn><issn>1469-8978</issn><eissn>1469-8978</eissn><abstract>Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>29380722</pmid><doi>10.1017/S0033291718000065</doi><tpages>12</tpages></addata></record> |
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| ispartof | Psychological medicine, 2018-09, Vol.48 (12), p.1954-1965 |
| issn | 0033-2917 1469-8978 1469-8978 |
| language | eng |
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| source | MEDLINE; Cambridge Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | absenteeism Adjustment adjustment disorder Anxiety Bias CBT Clinical trials Cognitive ability Cognitive behavioral therapy common mental disorders depression Health services Humans Insomnia Integrated care Intervention Mental depression Mental disorders Mental Disorders - rehabilitation Meta-analysis Occupational health Outcome Assessment (Health Care) - statistics & numerical data Problem solving PST Psychiatric symptoms Psychology Psychotherapy Psychotherapy - statistics & numerical data psykologi Quality Return to Work review Sick Leave Symptoms Systematic review |
| title | Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders |
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