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Abstract
To compare an innovative activating intervention with "care as usual" (control group)
for the guidance of employees on sickness leave because of an adjustment disorder.
It was hypothesised that the intervention would be more effective than care as usual
in lowering the intensity of symptoms, increasing psychological resources, and decreasing
sickness leave duration.
A prospective, cluster randomised controlled trial was carried out with 192 patients
on first sickness leave for an adjustment disorder. Symptom intensity, sickness duration,
and return to work rates were measured at 3 months and 12 months. Analyses were performed
on an intention to treat basis.
At 3 months, significantly more patients in the intervention group had returned to
work compared with the control group. At 12 months all patients had returned to work,
but sickness leave was shorter in the intervention group than in the control group.
The recurrence rate was lower in the intervention group. There were no differences
between the two study groups with regard to the decrease of symptoms. At baseline,
symptom intensity was higher in the patients than in a normal reference population,
but decreased over time in a similar manner in both groups to approximately normal
levels.
The experimental intervention for adjustment disorders was successful in shortening
sick leave duration, mainly by decreasing long term absenteeism.