Work-related treatment for major depressive disorder and incapacity to work: Preliminary findings of a controlled, matched study.

Abstract

The aim of this study was to compare the effectiveness of work-related cognitive-behavioral treatment (W-CBT) with that of cognitive-behavioral treatment as usual (CBT-AU) for employees on sick leave as a result of a major depressive disorder (MDD). We collected data for 26 matched outpatients at pre- and posttreatment, as well as at 1-year follow-up. Outcome measures were the days of incapacity to work (DIW) as well as self-report measures (Beck Depression Inventory [BDI], Symptom Checklist 90-R [GSI], Life Satisfaction Questionnaire [FLZ]). We analyzed data with hierarchical linear modeling in a 2-level model. Therapy effects were defined in 3 ways: effect size (ES), response (based on the reliable change index), and remission compared with the general population's symptom level. The DIW were reduced significantly after both types of treatment, but employees showed even fewer DIW after W-CBT. At follow-up, significantly more employees were working as a result of W-CBT than with CBT-AU. Significant improvements on scores of self-rating measures corresponded with moderate-to-large effect sizes for both treatment types. Approximately 2 thirds of the treated employees were categorized as unimpaired on BDI scores at posttreatment and at follow-up. At least 1 half of the employees were classified as unimpaired on GSI scores at both assessment points. In future research, a randomized controlled trial should be conducted using a larger sample size to investigate the impact of moderators (e.g., employees at different branches of the company). Findings provided support for using common CBT techniques to enhance return to work without losing expected improvements at the symptom level.

Interpersonal Psychotherapy vs. Treatment as Usual for Major Depression Related to Work Stress: A Pilot Randomized Controlled Study

“…However, those differences did not reach significance, most probably due to the small sample size of this pilot study. The decrease of depressive symptoms with W-IPT is in line with randomized controlled trials that investigated CBT workplace interventions (16,17,34). Compared to a workrelated CBT approach (34) including 24 weekly individual sessions which reached an effect size of d = 1.63 (pre-to posttreatment), W-IPT showed an effect size of d = 0.92 after only 8 weekly group sessions, and d = 2.14 at the 3-months follow-up, respectively.…”

Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials

“…For the duration of treatment, longer treatments were associated with higher ES. However, when one study with the longest treatment duration (Kröger et al 2015) was excluded from the analysis, this ES was no longer significant suggesting that this result is not robust. For categorical outcomes, there was no moderation of methodological quality.…”

Arbeitsplatzbezogene kognitive Verhaltenstherapie mit Fokus auf die Rückkehr an den Arbeitsplatz: Zwei Fallbeschreibungen

“…In einer anderen kontrollierten Studie [Kröger et al, 2014a] wurde eine arbeitsplatzbezogene KVT (A-KVT) mit der herkömm-lichen KVT bei unipolarer Depression verglichen (N = 26). Neben der Anzahl der Fehltage als primärer Endpunkt wurde ebenso die psychische Belastung erhoben.…”