Very few studies assessing recovery expectations use a psychometrically valid measure. Current evidence suggests that patients with lower recovery expectations are less likely to resolve their disability claim or return to work versus patients with higher recovery expectations. Further validation of existing measures for assessing patient recovery expectations, or development of a new measure that addresses the limitations of existing ones, is required.

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ObjectivesTo systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits.Data SourcesAll relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles.Study Eligibility Criteria, Participants and InterventionAdult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual.Study Appraisal and Synthesis MethodsThree teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data.ResultsOf 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = −2.61 (−5.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = −4.46 (−12.21, 3.30), p = 0.26.ConclusionsOur data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small.

improving information regarding to the work-related diseases and, more specifically, on the trend and variation of benefits paid for them. Method Through the NTEP it is possible to establish a nexus for each area of the economic activity, focusing on data of incapacitating diseases recognised by social welfare and involving more than 15 days' absence from work, using the ICD-10. Results Benefits for work-related diseases increased 128.2% during [2005][2006][2007][2008]. However, the greatest changes occurred after 2007. From May 2006 to March 2007, when only the employer's CAT was used, 125 246 Accident and Disease Assistance authorizations were issued. But, with the addition of the NTEP to the CAT this number rose to 293 912, an increase of 134.7% over the period from April 2007 to February 2008. The detachable figures are for "musculoskeletal system and connective tissue" (107 764 cases), "mental and behavioural disorders" (8930 cases), "and "diseases of the nervous system" (8396 cases). Conclusions The accident benefits for work-related diseases are growing more than other welfare benefits. This reality requires more studies and technical insights as well as priorities in terms of specific strategies for OSH policy. Objectives To investigate the association between job strain, social support at work and insomnia among registered nurses. Method A cross-sectional study was conducted among 3.229 nurses (87% women) in 18 major public hospitals in Rio de Janeiro/Brazil. Data collection was based on a comprehensive self-filled questionnaire that included questions on insomnia and the Job Content Questionnaire (JCQ). Job strain (high psychological demands and low control) and social support were evaluated by the Portuguese version of the 2.0-JCQ, defined by the quadrant approach. In addition, emotional demands were also assessed, so that high strain was evaluated considering separately the psychological and the emotional demands. Insomnia was defined as having at least one of the insomnia symptoms: difficulty initiating sleep, maintaining sleep or early morning awakening. Multivariate logistic regression and adjusted odds ratios and 95% confidence intervals were calculated. Results The overall prevalence of insomnia was 34.3%. Individuals with high job strain and low social support experienced insomnia more frequently (p < 0.05). After adjusting for sociodemographic, work and health-related variables, high strain doubled the chances of presenting insomnia considering both the psychological (OR=2.20, CI 1.74-2.78) and the emotional demands (OR=1.99, CI 1.57-2.53). High strain in combination with low support at work increased the chances of insomnia even more. Conclusions High strain is suggested as a possible risk factor for insomnia considering both psychological and emotional demands. The lack of social support from co-workers and supervisors seem to potentiate the odds for insomnia. Objectives Benzene is a well-known haematological toxin causing aplastic anaemia and leukaemia. Recent studies showed that low level ...

Objectives: To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits.Data Sources: All relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles.Study Eligibility Criteria, Participants and Intervention: Adult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual.Study Appraisal and Synthesis Methods: Three teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data.Results: Of 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = 22.61 (25.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = 24.46 (212.21, 3.30), p = 0.26.Conclusions: Our data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small.