Adjuvant occupational therapy improves long-term depression recovery and return-to-work in good health in sick-listed employees with major depression: results of a randomised controlled trial
Abstract
OBJECTIVES: To evaluate whether adjuvant occupational therapy (OT) can improve the effectiveness of treatment-as-usual (TAU) in sick-listed employees with major depression. METHODS: In total, 117 employees sick-listed for a median duration of 4.8 months (IQR=2.6 to 10.1 months) because of major depression were randomised to TAU (n=39) or adjuvant OT (TAU+OT; n=78). OT (18 sessions) focussed on a fast return to work (RTW) and improving work-related coping and self-efficacy. The primary outcome was work participation (hours of absenteeism+duration until partial/full RTW). Secondary outcomes were depression, at-work functioning, and health-related functioning. Intermediate outcomes were work-related, coping and self-efficacy. Blinded assessments occurred at baseline and 6, 12 and 18 months follow-up. RESULTS: The groups did not significantly differ in their overall work participation (adjusted group difference=-1.9, 95% CI -19.9 to +16.2). However, those in TAU+OT did show greater improvement in depression symptoms (-2.8, -5.5 to -0.2), an increased probability of long-term symptom remission (+18%, +7% to +30%), and increased probability of long-term RTW in good health (GH) (+24%, 12% to 36%). There were no significant group differences in the remaining secondary/intermediate outcomes. CONCLUSIONS: In a highly impaired population, we could not demonstrate significant benefit of adjuvant OT for improving overall work participation. However, adjuvant OT did increase long-term depression recovery and long-term RTW in GH (ie, full RTW while being remitted, and with better work and role functioning). TRIAL REGISTRATION DUTCH TRIAL REGISTER: NTR2057.
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Using occupational therapies for employees with depression as an analogous example, such therapies are employed over several months, after which a person can resume work (Hees et al., 2013; Hees et al., 2010).
“However, using occupational therapies for employees with depression as an analogous example, it is not uncommon that such therapies are employed over the course of several months, after which a person can resume work (Hees et al., 2013; Hees et al., 2010).”
From The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials (2020) · cites this paper as Hees et al., 2013
The participants in the present study had been on sick leave for an extremely long time (mean 7.8 years) and may not be fully comparable to other studies.
“In comparison to the above presented studies whose participants had been on sick leave for a maximum of 1 year [31, 32, 38, 39], the participants in the present study had been on sick leave for an extremely long time (a mean time of 7.8 years) and may therefore not be fully comparable to other studies.”
From Strengthened General Self-Efficacy with Multidisciplinary Vocational Rehabilitation in Women on Long-Term Sick Leave: A Randomised Controlled Trial. (2018) · cites this paper as [38]
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References 41 · Cited by 116
- Authors
- Hees, H. L., de Vries, G., Koeter, M. W. J., & Schene, A. H.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Hees, Hiske L
- ORCID
- Schene, Aart H
- Venue
- Occupational and Environmental Medicine
- Publisher
- BMJ
- Published
- 2012-11-01
- Volume
- 70
- Issue
- 4
- Pages
- 252-260
- ISSN
- 0007-1072 (ISSN-L)
- 1351-0711
- 1470-7926
- OpenAlex
- W2164304450
- Cited by
- 116
- References
- 41
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 20 · 2021: 7 · 2020: 9 · 2019: 9 · 2018: 12 · 2017: 12 · 2016: 11 · 2015: 6 · 2014: 5 · 2013: 6
- FWCI
- 16.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Occupational and Environmental Medicine (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- 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
- Keywords
- occupational therapy, major depressive disorder, sick-listed employees, return to work, work participation, depression remission, self-efficacy, absenteeism, health-related functioning
- MeSH terms
- Absenteeism, Adaptation, Psychological, Adult, Depression, Major Depressive Disorder, Female, Follow-Up Studies, Health, Humans, Male, Middle Aged, Occupational Therapy, Remission Induction, Program Evaluation, Treatment Outcome, Sick Leave, Self Efficacy, Return to Work
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