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Cited by 30Workplace Health and Well-beingStress and Burnout ResearchMedical Practices and Rehabilitation

Standardized multimodal intervention for stress-induced exhaustion disorder: an open trial in a clinical setting

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van de Leur, Jakob Clason, Buhrman, Monica, Åhs, Fredrik, Rozental, Alexander, Jansen, Gunilla Brodda·2020·BMC Psychiatry
DOI 10.1186/s12888-020-02907-3PMC PMC7643309
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Abstract

Background: Long-term sick-leave due to stress-related ill-health is increasing in several economically developed countries. Even though different forms of interventions are administered in regular care for stress-related disorders, such as Stress-induced Exhaustion disorder (SED), the scientific evidence for the effectiveness of such treatments is sparse. The objective of this study was to explore changes in SED-symptoms and return-to-work-rates in a large group of SED-patients participating in a standardized Multimodal intervention (MMI) in a clinical setting. Method: This open clinical trial tracked 390 patients who fulfilled the criteria for SED undergoing a 24-week MMI, including return-to-work-strategies. Before inclusion, all patients underwent a multi-professional assessment by a team of licensed physicians, licensed psychologists, and licensed physiotherapists. Self-rated questionnaires were administered before treatment, at treatment-start, mid-treatment, post-treatment, and at 12-month follow-up. Within-group change was evaluated over time with mixed-effects models. Beyond different symptoms, working time, sick-leave compensation, and adverse effects were also measured. Results: There were significant improvements in symptoms of SED, burnout, anxiety, depression, and insomnia, with large within-group effect sizes (d = 0.91–1.76), improvements that were maintained at 12-month follow-up. Furthermore, there was a significant increase in quality of life and large improvements in average working time and sick-leave compensation. Some adverse effects were reported, mainly concerning an increase in stress, anxiety, and worry. Conclusion: SED-patients participating in this standardized MMI reported large symptom alleviation, increased working time and reduced sick-leave compensation, indicating a beneficial treatment. There were some adverse effects, but no more so than other psychological treatments. This study confirms previous findings that high levels of depression and anxiety decrease to sub-clinical levels during treatment, while symptoms of SED also decline, yet still persists above sub-clinical levels at 12-month follow-up. On the whole, this open clinical trial suggests that a standardized MMI, administered in a clinical setting, improves symptoms and return-to-work rates in a clinically representative SED-population. Trial registration: This study was registered on Clinicaltrials.gov 2017.12.02 (Identifier: NCT03360136).

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Cited by

Sorted by citations

Authors
van de Leur, J. C., Buhrman, M., Åhs, F., Rozental, A., & Jansen, G. B.
Affiliations
  • Uppsala University (SE)
  • Mid Sweden University (SE)
  • Karolinska Institutet (SE)
  • Danderyds sjukhus (SE)
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2020-11-05
Volume
20
Issue
1
Pages
526-526
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-020-02907-3
PMC
PMC7643309
OpenAlex
W3095977449
Cited by
30
References
21
Citations by year
2025: 8 · 2024: 2 · 2023: 13 · 2022: 4 · 2021: 3
FWCI
5.22
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Publications (Mid Sweden University) (submittedVersion, other-oa)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Forskningsrådet om Hälsa, Arbetsliv och Välfärd (2018-00154)
Topics
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
multimodal intervention, return to work, sick leave, burnout, anxiety, depression, insomnia, quality of life, adverse effects, occupational stress, psychological intervention
MeSH terms
Anxiety, Humans, Quality of Life, Surveys and Questionnaires, Sick Leave, Return to Work

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