Abstract
BackgroundCommon mental disorders such as depression and anxiety are major contributors to the global burden of disease. Affected individuals suffer reduced quality of life, impaired functioning and reduced capacity to work. Maintaining employment is an important determinant for health and wellbeing, and the economic impact of depression and anxiety is a significant societal expense. Treatments providing effective symptom reduction and helping patients return to work (RTW) would thus have substantial public health benefits. The present study will explore the effectiveness of metacognitive therapy (MCT) and work-focused interventions on reducing symptoms and increasing RTW rates for patients on sick leave due to depression and anxiety.MethodsThe study is a randomised controlled wait-list trial (RCT; N = 240). The intervention group will receive protocol-based MCT and work-focused interventions immediately after inclusion. The control condition is a wait-list control group. All patients will receive up to 12 weekly sessions. The study context is a Norwegian outpatient clinic part of a national programme aimed at reducing sick leave. The co-primary outcomes are change in RTW and symptoms of depression and anxiety at the end of treatment. In addition to self-report, sick leave will also be collected from national registries from 2 years prior to intervention to 4 years after intervention. Symptoms of depression and anxiety will be collected by self-report at pre- and post-treatment and at 6 and 12 months follow-up after treatment. A cost-effectiveness analysis will use total cost and quality-adjusted life-years as the secondary outcomes.DiscussionThere is broad consensus on the importance of identifying treatment that effectively reduces depression and anxiety symptoms and aids RTW. This study is an important contribution to the field as it is the first RCT on MCT and work-focused interventions for patients on sick leave due to anxiety and depression.Trial registrationClinicalTrials.gov NCT03301922. Registered on October 4, 2017.
Highlights
Common mental disorders such as depression and anxiety are major contributors to the global burden of disease
Recent estimates indicate that mental illness may account for nearly a third (32.4%) of total years lived with disability, making it the main contributor to the global burden of disease [1]
There is broad agreement that treatment for patients on sick leave due to depression and anxiety should aim to help patients remain at work, or in the case of sick leave, return to work (RTW) [10]
Summary
Common mental disorders such as depression and anxiety are major contributors to the global burden of disease. Treatments providing effective symptom reduction and helping patients return to work (RTW) would have substantial public health benefits. Recent estimates indicate that mental illness may account for nearly a third (32.4%) of total years lived with disability, making it the main contributor to the global burden of disease [1]. Common mental disorders such as depression and anxiety are the most prevalent mental illnesses and account for the largest share of the disease burden [2, 3]. There is broad agreement that treatment for patients on sick leave due to depression and anxiety should aim to help patients remain at work, or in the case of sick leave, return to work (RTW) [10]
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