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Cochrane Database of Systematic Reviews

Interventions to facilitate return to work in adults with adjustment disorders

Information

DOI:
https://doi.org/10.1002/14651858.CD006389.pub2Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 12 December 2012see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Common Mental Disorders Group

Copyright:
  1. Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Iris Arends

    Correspondence to: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands

    [email protected]

  • David J Bruinvels

    People and Work Outpatient Clinic, Academic Medical Center, Amsterdam, Netherlands

  • David S Rebergen

    PsychoVitaal, Amstelveen, Netherlands

  • Karen Nieuwenhuijsen

    Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands

  • Ira Madan

    Guy's and St Thomas NHS Foundation Trust, London, UK

  • Angela Neumeyer‐Gromen

    Deutsche Krankenhausgesellschaft (German Hospital Society), Berlin, Germany

  • Ute Bültmann

    Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands

  • Jos H Verbeek

    Cochrane Occupational Safety and Health Review Group, Finnish Institute of Occupational Health, Kuopio, Finland

Contributions of authors

DB wrote the protocol and IA wrote the systematic review. IA, DB, UB and KN included eligible studies, and JV helped when authors could not agree. IA and UB did the 'Risk of bias' assessment and DB helped when these authors could not agree. DB, IA and AN conducted the data extraction from the original studies. IA contacted study authors for additional information. IA and JV conducted the data synthesis. DR, AN, IM and KN reviewed the protocol. AN, DB, DR, IM, KN, UB and JV reviewed the systematic review. All authors were involved in designing the search strategy and choosing the comparison groups for the data analyses.

Sources of support

Internal sources

  • EMGO Institute, Department of Public and Occupational Health, VU University Medical Center, Netherlands.

  • Community & Occupational Medicine, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

  • Ministry of Social Affairs and Employment, Netherlands.

    David Bruinvels received a grant as part of the Occupational Health Knowledge Infrastructure Programme of the Ministry

External sources

  • Dutch Cochrane Centre, Netherlands.

Declarations of interest

DR and DB are authors of one of the included studies, but they were not involved in the selection, 'Risk of bias' analysis or data extraction for this study.

IA and UB are the authors of a potentially eligible study for this review. They will not be involved in the selection, 'Risk of bias' analysis or data extraction for this study.

KN is the author of a potentially eligible study for this review. She will not be involved in the selection, 'Risk of bias' analysis or data extraction for this study.

IA, DB, DR, KN, IM, AN, UB and JV declare no financial conflicts of interest.

Acknowledgements

We would like to thank the Cochrane Occupational Safety and Health Group for their valuable comments and the Finnish Institute of Occupational Health for receiving the first author as a guest at the institute to complete the necessary analyses and to finalise the review text.

Version history

Published

Title

Stage

Authors

Version

2012 Dec 12

Interventions to facilitate return to work in adults with adjustment disorders

Review

Iris Arends, David J Bruinvels, David S Rebergen, Karen Nieuwenhuijsen, Ira Madan, Angela Neumeyer‐Gromen, Ute Bültmann, Jos H Verbeek

https://doi.org/10.1002/14651858.CD006389.pub2

2007 Jan 24

Return to work interventions for adjustment disorders

Protocol

David Bruinvels, David S Rebergen, Karen Nieuwenhuijsen, Ira Madan, Angela Neumeyer‐Gromen

https://doi.org/10.1002/14651858.CD006389

Differences between protocol and review

Authors: Iris Arends, Ute Bültmann and Jos Verbeek were added as review authors.

Title: The title has been changed from 'Return to work interventions for adjustment disorders' to 'Interventions to facilitate return to work in adults with adjustment disorders' as this better represents the topic of the review.

Types of studies: A more clear definition is given of the focus of the types of studies included in the review.

Types of participants: The word 'adults' is replaced by 'workers', because the review is not focused on all adults but only on working adults. Also, we have further operationalised the definition of 'adjustment disorder' because the definition of the protocol was insufficient to decide if studies were on workers with adjustment disorders and could be included on this point. The sentence in the protocol on including "patients in all organisational settings..." has been deleted because we felt this information was superfluous. Furthermore, we have added that studies could be included when not all participants were on sick leave at baseline (i.e. some were still at work), as long as the outcome data on sick leave/RTW were separately reported for the group that was on sick leave at baseline.

Types of interventions: The interventions (and the comparisons) are more thoroughly explained. Furthermore we added a mixed group of interventions, consisting of combined interventions, because otherwise we were not able to categorise an intervention that used a mixture of two or more interventions. We deleted the sentence on separately managing interventions aimed at the workplace, because we chose to categorise interventions based on their core elements instead of looking at the setting where they were implemented.

Types of outcomes: For the primary outcomes, we have chosen to minimise the number of outcomes presented in the protocol as per the advice in the Cochrane Handbook. We focused on time lost from work as the primary outcome and defined this more clearly as partial and full RTW, which is a frequently used outcome measure in the research literature for workers on sick leave. The other primary outcomes mentioned in the protocol have been grouped in the review as secondary outcome measures defined as work functioning. Two secondary outcome measures have been deleted. These were 'patient compliance to the intervention' and 'trial drop‐out', because these variables were already taken into account in the 'Risk of bias' analyses.

Search methods: Based on discussions with the Trial Search Co‐ordinator of the CCDAN Group, it was decided to search the CCDAN registers, CENTRAL, EMBASE, MEDLINE, PsycINFO, Web of Science, the WHO trials portal and ClinicalTrials.gov. The Trial Search Co‐ordinator helped with finding the right terms for adjustment disorders and randomised clinical trials. We decided not to use search terms for the interventions because we wanted to find all types of interventions and the naming of interventions varies widely. Instead, we used terms to identify studies on RTW or on workers on sick leave. We refrained from writing to all authors of articles because we felt that there was enough expertise in the review team, and this would unnecessarily burden the authors. We also refrained from searching congress abstracts as there was not just one forum of discussion, but proceedings of many different conferences should have been searched. This went beyond our resources.

Selection of studies: To enhance a structured first selection of studies based on title and abstract screening, we developed a standardised form with the following criteria: (1) study design is a RCT, (2) study population consists of a working population and (3) study population has common mental disorders (adjustment disorders, depressive disorders, anxiety disorders).

Assessment of risk of bias: In the protocol, a quality assessment with the Downs and Black list was planned. However, we decided to analyse the risk of bias in accordance with the recommendations made in the Cochrane Handbook.

Data extraction: No differences.

Data analysis: We changed the reporting of dichotomous outcome measures from odds ratios to risk ratios because the event of returning to work is quite common which inflates the odds ratio. Moreover, risk ratios are easier to interpret.