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Sickness absence: a systematic review and meta-analysis of psychological treatments for individuals on sick leave due to common mental disorders

Published online by Cambridge University Press:  30 January 2018

Sigrid Salomonsson ,
Erik Hedman-Lagerlöf  and
Lars-Göran Öst
Sigrid Salomonsson*
Affiliation:
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
Erik Hedman-Lagerlöf
Affiliation:
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
Lars-Göran Öst
Affiliation:
Department of Psychology, Stockholm University, Stockholm, Sweden
*
Author for correspondence: Sigrid Salomonsson, E-mail: sigrid.salomonsson@sll.se
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Abstract

Sick leave due to common mental disorders (CMDs) increase rapidly and present a major societal challenge. The overall effect of psychological interventions to reduce sick leave and symptoms has not been sufficiently investigated and there is a need for a systematic review and meta-analysis of the field. The aim of the present meta-analysis was to calculate the effect size of psychological interventions for CMDs on sick leave and psychiatric symptoms based on all published randomized controlled trials. Methodological quality, the risk of bias and publication bias were also assessed. The literature searches gave 2240 hits and 45 studies were included. The psychological interventions were more effective than care as usual on both reduced sick leave (g = 0.15) and symptoms (g = 0.21). There was no significant difference in effect between work focused interventions, problem-solving therapy, cognitive behavioural therapy or collaborative care. We conclude that psychological interventions are more effective than care as usual to reduce sick leave and symptoms but the effect sizes are small. More research is needed on psychological interventions that evaluate effects on sick leave. Consensual measures of sick leave should be established and quality of psychotherapy for patients on sick leave should be improved.

Keywords

Meta-analysissick leaveabsenteeismreturn-to-workreviewCBTPSTcommon mental disordersanxietydepressioninsomniaadjustment disorder
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 12 , September 2018 , pp. 1954 - 1965
Copyright
Copyright © Cambridge University Press 2018 

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