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Cited by 129Workplace Health and Well-beingMedical Practices and RehabilitationOccupational Therapy Practice and Research

Interventions to improve occupational health in depressed people

Nieuwenhuijsen, Karen, Bültmann, Ute, Neumeyer-Gromen, Angela, Verhoeven, Arco C, Verbeek, Jos H, Feltz-Cornelis, Christina M.·2008·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd006237.pub2
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Abstract

BACKGROUND: Work disability such as sickness absence is common in people with depression. OBJECTIVES: To evaluate the effectiveness of interventions aimed at reducing work disability in depressed workers. SEARCH STRATEGY: We searched the CCDANCTR-Studies and CCDANCTR-References on 2/8/2006, Cochrane Library CENTRAL register, MEDLINE, EMBASE, CINAHL, PsycINFO, OSH-ROM (Occupational Safety and Health), NHS-EED, and DARE. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and cluster RCTs of work-directed and worker-directed interventions for depressed people, using sickness absence as the primary outcome DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality. We used standardised mean differences (SMD) with 95% confidence intervals (CIs) to pool study results where possible. MAIN RESULTS: We included eleven studies, all of worker-directed interventions, involving 2556 participants. Only one study addressed work issues using adjuvant occupational therapy. Other interventions evaluated anti-depressant medication (selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, monoamino-oxidase inhibitors), psychodynamic therapy, enhanced primary care and psychological treatment. For medication, the combined results of three studies (n=864) showed no difference between antidepressant medication and alternative medication in their effect on days of sickness absence (SMD 0.09; 95% CI -0.05 to 0.23) In two pooled studies (n=969), the effect of enhanced primary care on days of sickness absence did not differ from usual care in the medium term (SMD -0.02; 95% CI -0.15 to 0.12). All other comparisons were based on single studies (n=6), all of which showed a lack of significant difference for sickness absence between groups, with the exception of one small study, combined psychodynamic therapy and TCAs versus TCAs alone, which favoured the combined treatment. AUTHORS' CONCLUSIONS: Based on a heterogeneous sample of studies, there is currently no evidence of an effect of medication alone, enhanced primary care, psychological interventions or the combination of those with medication on sickness absence of depressed workers. In future RCTs, interventions should specifically address work issues, and occupational outcomes should be used to measure the effect..

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Authors
Nieuwenhuijsen, K., Bültmann, U., Neumeyer-Gromen, A., Verhoeven, A. C., Verbeek, J. H., & Feltz-Cornelis, C. M.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • National Institute of Occupational Health (NO)
  • Finnish Institute of Occupational Health (FI)
  • Trimbos Institute (NL)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2008-04-23
Issue
2
Pages
CD006237-CD006237
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd006237.pub2
OpenAlex
W1863030634
Cited by
129
References
68
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 10 · 2016: 7 · 2015: 10 · 2014: 16 · 2013: 16 · 2012: 16
Type
reference entry
Language
en
Update notices
new_version (2014-12-03)
Open access
closed
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
Keywords
depression, occupational health, work disability, sick leave, antidepressants, selective serotonin reuptake inhibitors, tricyclic antidepressants, psychodynamic psychotherapy, enhanced primary care, psychological intervention, occupational therapy
MeSH terms
Absenteeism, Depression, Humans, Randomized Controlled Trials as Topic, Occupational Health

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