334
J. Wallensten et al.
Table III. Studies on populations with stress-related exhaustion and outcome return to work (RTW) from the unstructured search
divided into psychological and/or stress-reducing interventions, psychological and/or stress-reducing interventions + workplace-oriented
interventions and workplace-oriented interventions
Reference
Study design
Population
Psychological and/or stress-reducing interventions
Stenlund et al. RCT, qigong only as
Patients with burnout
2009 (55)
control
(n = 136)
Willert et al.
RCT with wait-list
Patients with symptoms of
2011 (80)
control
work-related stress (if on
sick leave they should plan
to go back to work in < 4
weeks) (n = 102)
Währborg et al. Retrospective cohort
Patients with mild to
2014 (63)
study with a matched
moderate depression and/
reference group who
or reactions to severe
received TAU (n = 678) stress (n = 118)
Intervention Intervention effect on RTW
Qigong + Cognitively oriented behavioural
Rehabilitation (30 sessions over a year)
Cognitive behavioural stress management
intervention No significant difference between the groups
at 12-month follow-up
Self-reported absenteeism from work,
but not RTW (register-based data), was
significantly lower at 4-month follow-up.
A nature-assisted rehabilitation
programme, designed as a
multimodal programme conducted in
a rehabilitation garden No significant difference between the groups
up to 24 months after inclusion
Psychological and/or stress-reducing interventions + workplace-oriented interventions
Patients on sick leave due Intervention programme with psychological
Lander et al.
Non-randomized
2009 (81)
controlled interventional to emotional stress (n = 72) stress management and case management
study, TAU as control
(psychoeducative treatment/advice and
(n = 89)
support concerning resuming work,
participating in meetings with employers
and facilitating contacts with work)
Arends et al.
Systematic review
Patients with adjustment
Psychological (such as CBT and PST),
2012 (33)
disorder (n = 1,546)
pharmacological, relaxation, physical and
employee assistance interventions
RCT with TAU as control Patients on sick leave due
to depression, anxiety or
stress-related disorders
(n = 352)
Dalgaard et al.
2017 (31, 32) RCT with 2 control
groups; clinical
examination or TAU
Workplace-oriented interventions
Blonk et al.
RCT with controls
Self-employed patients
2006 (84)
receiving 2 sessions with on sick leave due to
a general practitioner
work-related psychological
complaints (i.e. adjustment
disorders, such as burnout
and job stress) (n = 122)
Bakker et al.
Cluster-RCT
Patients with stress-related
2007(82)
mental disorder (n = 433)
with TAU as control
Van Oostrom et RCT with controls
al. 2010 (90)
receiving usual care.
Eklund et al.
2011 (85)
Quasi-experimental
study with TAU as
control
Lagerveld et al. Quasi-experimental
2012 (76)
design with CBT as
control
Netterstrom et
al. 2013 (50)
Karlson et al.
2010 (78),
Karlson et al.
2014 (79)
PST, but no other intervention,
significantly
shortened time to RTW (partial RTW and
12-month follow-up)
Three intervention groups; (a) ACT, (b)
At 9-month follow-up participants with
workplace dialogue intervention, (c) ACT+ stress-related disorders had significantly
workplace dialogue intervention
fewer sick leave days in the workplace
dialogue intervention group compared with
TAU
Patients on sick leave due Individual CBT + offer of a minor
Significantly faster lasting RTW at 44 weeks
to work-related stress
workplace intervention
compared with the control group receiving
diagnosed with adjustment
clinical examination
disorder, reaction to severe
stress or mild depressive
episode (n = 163)
Patients with common
CBT, RTW intervention and a combination No significant difference between the groups
mental disorders (n = 211) of CBT and RTW intervention.
regarding sick leave.
Patients on sick leave
CBT, PST and work-focused interventions, The interventions were more effective than
due to common mental
for common mental disorders.
TAU for reducing sick leave. The effect did
disorders
not differ significantly between CBT, PST and
work-focused interventions
Finnes et al.
2016 (83)
Salomonsson et RCT
al. 2017 (86)
Salomonsson et Systematic review and
al. 2018 (36)
meta-analysis
No significant difference in RTW between the
groups within 17 months.
CBT alone, conducted by psychotherapists
and a combined intervention including brief
CBT + workplace and individual-focused
techniques delivered by a labour expert
(including graded activity and workplace
interventions)
Training in Minimal Intervention for Stress-
related mental disorders with Sick leave for
primary care physicians
Sick-listed employees with WI including a stepwise process involving
distress (n = 145)
the patients and their supervisor aiming to
reduce obstacles for RTW
Patients on sick leave for
16-week group-based programme
stress-related disorders
comprising occupational self-analysis, goal-
(n = 42)
setting and strategies for accomplishing
desired changes, and work placement
Patients on sick leave
Work-focused CBT integrating work aspects
due to common mental
early into the treatment
disorders, including
adjustment disorder
(n = 168)
Patients on sick leave
Workplace-focused psychotherapy including
with symptoms of
a workplace dialogue if the patient agreed
persistent work-
and a mindfulness-based stress- reduction
related stress (n = 199)
course (group-based, eight sessions every
week over eight weeks)
RCT with 2 control
groups; (a) TAU
(including individual
sessions with a
psychologist) and (b)
wait list
Prospective controlled
Patients with SED (n = 74)
study with patients
with SED who were
not interested in
participating in the
intervention as controls
Workplace-oriented intervention aimed
to facilitate RTW by initiating a dialogue
between the patient and the supervisor to
find solutions to facilitate RTW
The combined intervention had significantly
earlier RTW, both partial and full time at
10-months follow-up
No significant effect on sick leave at
12-month follow-up
Significant reduced time until lasting RTW
in patients who intended to RTW despite
symptoms at baseline.
Significantly increased RTW at 6- and
12-month follow-up
Significantly earlier RTW, both partial and
full time at 12-month follow-up
Significantly more patients had full-time
RTW after the treatment
Significantly increased RTW at 1.5 years
follow-up, which remained only in subjects
younger than 46 years at 2.5-years follow-
up
RTW: return to work; RCT: randomized controlled trial; TAU: treatment as usual; CBT: cognitive behavioural therapy; PST: problem-solving therapy; ACT: acceptance
and commitment therapy; SED: stress-induced exhaustion disorder. Grey shaded cells indicate intervention effect.
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