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Pre-existing anxiety and depression disorders and return to work after musculoskeletal strain or sprain: a phased-based approach

Abstract

Purpose

To examine the impact of pre-existing anxiety and depression disorders on return to work (RTW) using a phase-based approach.

Methods

Accepted lost-time workers’ compensation claims for upper limb or spine strain or sprain from 2009 to 2013 were extracted for workers in the Canadian province of British Columbia (n = 78,186). Pre-existing anxiety and depression disorders were identified using health claims data. Probability of RTW following a first or second work lost-time episode was analyzed using Prentice, Williams and Peterson models for recurrent events (common hazards ratios (cHR)). Probability of a first lost-time recurrence was analyzed using Cox models (HR). All models included two years of follow up and were stratified by gender.

Results

For men, anxiety alone (cHR = 0.90, 95% CI: 0.85 to 0.94) or comorbid with depression (cHR = 0.95, 95% CI: 0.92 to 0.99) was significantly associated with a lower probability of RTW, and comorbid anxiety and depression with a higher probability of recurrence (HR = 1.29, 95% CI: 1.13 to 1.48). In women, comorbid anxiety and depression was significantly associated with a lower probability of RTW (cHR = 0.96, 95% CI: 0.93 to 0.99) and a higher probability of recurrence (HR = 1.15, 95% CI: 1.04 to 1.28); and anxiety alone with a higher probability of recurrence (HR = 1.25, 95% CI: 1.09 to 1.43). There was little evidence that depression alone was associated with RTW or recurrence.

Conclusions

Workers with a pre-existing anxiety disorder may require additional supports both during lost-time and after initial RTW.

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Availability of data and material:

Data may be obtained from a third party and are not publicly available. The workers’ compensation and health claims data used for this study were made available to the researchers by Population Data BC (www.popdata.bc. ca.) with permission from the data stewards. The data was made available for the sole purposes of achieving the research objectives and is not available for sharing.

Code Availability

The code for this research is stored on a secure research server for privacy reasons. Sections of the code not containing sensitive information can be made available upon request for specified reasons or purposes.

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Acknowledgements

Andrea Marie Jones was supported by a WorkSafeBC Research Training Award, Centre for Research on Work Disability Policy Student Trainee Award, and Bridge Canadian Institutes for Health Research (CIHR) Strategic Training Fellowship. Mieke Koehoorn was supported in part by a CIHR Chair in Gender, Work and Health. Christopher McLeod was supported by a CIHR New Investigator Award and is supported by a Michael Smith Foundation for Health Research Scholar Award. Andrea Marie Jones, Mieke Koehoorn, and Christopher McLeod are supported by research operating funds through the Partnership for Work Health and Safety - a research partnership between WorkSafeBC (the provincial workers’ compensation system) and the University of British Columbia.

Funding

Andrea Marie Jones was supported by a WorkSafeBC Research Training Award, Centre for Research on Work Disability Policy Student Trainee Award, and Bridge CIHR Strategic Training Fellowship. Mieke Koehoorn was supported in part by a CIHR Chair in Gender, Work and Health. Christopher McLeod was supported by a CIHR New Investigator Award and is supported by a MSFHR Scholar Award. Andrea Marie Jones, Mieke Koehoorn, and Christopher McLeod are supported by research operating funds through the Partnership for Work Health and Safety - a research partnership between WorkSafeBC (the provincial workers’ compensation system) and the University of British Columbia.

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Contributions

All authors contributed to the study conception and design. Data cleaning and analyses were performed by Andrea Marie Jones. The first draft of the manuscript was written by Andrea Marie Jones and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Andrea Marie Jones PhD.

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Certificate #H15-02150) from the Behavioural Research Ethics Board at the University of British Columbia.

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Jones, A.M., Koehoorn, M., Bültmann, U. et al. Pre-existing anxiety and depression disorders and return to work after musculoskeletal strain or sprain: a phased-based approach. J Occup Rehabil (2022). https://doi.org/10.1007/s10926-022-10047-6

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Keywords

  • Depression
  • Anxiety
  • Comorbidity
  • Work
  • Sprains and strains