BackgroundLong-term sick leave has considerably negative impact on the individual and society. Hence, the need to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupational rehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorous evaluation has been performed. The described randomized controlled trial aims primarily to compare two structured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparative cognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usual care reference group.Methods/designThe study is designed as a randomized controlled trial with parallel groups. The Social Security Office performs monthly extractions of sick listed individuals aged 18–60 years, on sick leave 2–12 months, with sick leave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomized twice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter “untouched” control group will be monitored for future sick leave in the National Social Security Register, and 2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on which invitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long program consists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by two weeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mental training, physical training and work-related problem solving. The primary outcome is number of sick leave days. Secondary outcomes include time until full sustainable return to work, health related quality of life, health related behavior, functional status, somatic and mental health, and perceptions of work. In addition, health economic evaluation will be performed, and the implementation of the interventions, expectations and experiences of users and service providers will be investigated with different qualitative methods.Trial registrationClinicalTrials.gov: NCT01926574.

Objectives We aimed to investigate how mental distress was associated with pain and injuries in a convenience sample of construction workers. Methods A cross-sectional, mental health assessment was conducted in a convenience sample of construction workers (N=172). A subsample participated in a clinical interview (N=10). We used a cut-off (≥1.50) on HSCL-25 to determine substantial mental distress and determined associations with pain and injury outcomes. Results The prevalence of substantial mental distress was 16 % in the workers. This was supported by follow-up clinical interviews where nine out of ten workers fulfilled the criteria for a mental disorder. Substantial mental distress was associated with both injury rate and self-reported pain. Conclusion This pilot study strongly suggests the need for rigorous studies on construction worker mental health, and how it affects their work and wellbeing.

Three to four weeks of inpatient occupational rehabilitation is mainstream in Scandinavia, but the effects have not been investigated. This is the first study to show that, among individuals on long-term sickness absence due to musculoskeletal-or common mental disorders, 3.5 weeks of inpatient multimodal occupational rehabilitation significantly reduced sickness absence compared with 6 weekly sessions of outpatient acceptance and commitment therapy.