Effects of Additional Individually Tailored Interventions on Sick-Leave and Symptoms in Patients with Exhaustion Disorder: A Randomized Controlled Trial

Abstract

Objective: To evaluate the effects of adding individually tailored interventions to a standard treatment in patients with stress-related exhaustion disorder, with regard to sick-leave days and symptoms of burnout. The study design was a 2-armed randomized controlled intervention, with follow-up after 15 months. Data were obtained from patients referred to the Institute of Stress Medicine, and were collected between 2011 and 2014 in western Sweden.Methods: Inclusion criteria were scoring above cutoff in at least 1 of 4 dimensions; mental and physical exhaustion, disturbed sleep, reduced cognitive function and perceived poor self-esteem. The total study population comprised 142 patients (112 females, 30 males) allocated through block randomization to either the intervention group (n = 71) or the control group (n = 71). The intervention group received 1–4 individually tailored interventions (physical activity, cognitive behaviour therapy for insomnia, computerized memory training, cognitive behavioural therapy for self-esteem), based on the results of screening assessments. The interventions were additional to a standard treatment. The control group received solely the standard treatment. The primary outcome measure was the proportion of participants not sicklisted at the 15-month follow-up.Results: At the 15-month follow-up, 30% of subjects in the intervention group and 34% in the control group had 0% sick-listed (p = 0.58). No change between baseline and follow-up was seen in 42% of the intervention group and 39% of the control group, while an increased sick-leave rate was seen in 1% of the intervention group and 4% of the control group. However, no statistically significant difference was seen between groups.Conclusion: Adding individually tailored interventions to a standard treatment in patients with stress-related exhaustion did not reduce sick-leave days or burnout symptoms.

Return-to-work interventions for sick-listed employees with burnout: a systematic review

“… 41 Besides the studies where involvement of the workplace is integrated in the intervention, two other studies in this review describe a person-directed intervention, but workplace involvement is present in both the intervention group and the comparator group. In one study, employers and colleagues received, on the initiative of the patient, information about the disease and the consequences of the disease for everyday life in both the intervention group and the control group; 31 in the other study, a rehabilitation meeting was organised in both the intervention group and the control group. 34 The lack of a clear distinction between intervention group and controls in terms of potential effective measures to facilitate RTW makes it difficult to draw firm conclusions on which intervention is (most) effective.…”