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Trajectories of Return to Work Among People on Sick Leave with Mood or Anxiety Disorders: Secondary Analysis from a Randomized Controlled Trial

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Abstract

Purpose The return to work (RTW) of people with mood and anxiety disorders is a heterogeneous process. We aimed to identify prototypical trajectories of RTW over a two-year period in people on sick leave with mood and anxiety disorders, and investigate if socio-demographic or clinical factors predicted trajectory membership. Methods We used data from the randomized IPS-MA trial (n = 283), evaluating a supported employment intervention for participants with recently diagnosed mood or anxiety disorders. Information on “weeks in employment in the past 6 months” was measured after 1/2, 1, 1 ½ and 2 years, using data from a nationwide Danish register (DREAM). Latent growth mixture modelling analysis was carried out to identify trajectories of RTW and logistic regression analyses were used to estimate predictors for trajectory membership. Results Four trajectory classes of RTW were identified; non-RTW [70% (196/283)] (practically no return to work); delayed-RTW [19% (56/283)] (6 months delay before full RTW); rapid-unstable-RTW [7% (19/283)] (members rapidly returned to work, but only worked half the time); and the smallest class, rapid-RTW [4% (12/283)] (members rapidly reached full employment, but later experienced a decrease in weeks of employment). Self-reported disability score according to the SDS, not living with a partner, and readiness to change on the CQ scale were found to be significantly associated with RTW. Conclusion The trajectories identified support that many do not benefit from vocational rehabilitation, or experience difficulties sustaining employment; enhanced support of this patient group is still warranted.

Trial registration: http://www.clinicaltrials.gov (Identifier: NCT01721824)

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Funding

The randomized trial was funded by the Obel Family Foundation, the Tryg Foundation, and the Danish Agency for Labour Market and Recruitment. No current or future sponsors of the trial have had any role in the trial design, collection of data, analysis of data, data interpretation, or in publication of data from the trial.

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Authors and Affiliations

  1. Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark

    Lone Hellström, Trine Madsen, Merete Nordentoft & Lene Falgaard Eplov

  2. Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Dyrehavevej 48, 3400, Hillerød, Denmark

    Per Bech

  3. Research Unit, Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark

    Lone Hellström

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  1. Lone Hellström
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Contributions

LH did the scientific literature search, study design of analysis, participated in the data analysis, data interpretation, drafting of figures and writing of the manuscript. TM participated in the study design of analysis, conducted the data analysis, data interpretation, drafting of figures and co-writing of the manuscript. LFE took part in planning and design of the study, interpretation of analysis and co-writing of the manuscript. PB and MN took part in interpretation of the analysis, and co-writing of the manuscript. All authors have read and critically revised the manuscript.

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Correspondence to Lone Hellström.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by The Regional Ethics Committees of the Capital Region (journal no: H-2-2011-FSP20), reported to the Danish Data Protection Agency (Journal no: 2007-58-0015, local Journal no: RHP-2011-20), and registered at http://www.clinicaltrials.gov (Identifier: NCT01721824).

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All participants provided oral and written informed consent prior to inclusion in the study.

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Hellström, L., Madsen, T., Nordentoft, M. et al. Trajectories of Return to Work Among People on Sick Leave with Mood or Anxiety Disorders: Secondary Analysis from a Randomized Controlled Trial. J Occup Rehabil 28, 666–677 (2018). https://doi.org/10.1007/s10926-017-9750-x

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