Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial |
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| Authors: | Sigrid Salomonsson Fredrik Santoft Elin Lindsäter Kersti Ejeby Martin Ingvar Brjánn Ljótsson Lars-Göran Öst Mats Lekander Erik Hedman-Lagerlöf |
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| Institution: | 1. Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;2. Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden;3. Department of Neurobiology, Division of Family medicine, Care Sciences and Society (NVS), H1, Karolinska Institutet, Stockholm, Sweden;4. Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden |
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| Abstract: | The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder. |
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| Keywords: | Stress exhaustion disorder CBT return-to-work adjustment disorder depression |
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