The effect of detecting undetected common mental disorders on psychological distress and quality of life in long-term sickness absence: A randomised controlled trial

Abstract

Background: The burden imposed by common mental disorders on individuals and society calls for interventions aimed at reducing psychological distress and improving quality of life. Aim: To study whether detection of mental disorders plus feedback to individuals and caregivers reduces psychological distress and improves quality of life in long-term sickness absence (LSA), defined as continuous sick-leave for more than 8 weeks. Mental disorders were detected by Present State Examination. Methods: The study population comprised 118,000 inhabitants. During 1 year, all incident individuals on LSA were identified from public registers regarding sickness transfer income. Common Mental Disorders Screening Questionnaire (CMD-SQ) (psychological distress) and SF-36 (quality of life) were sent to 2414 incident individuals on LSA, response rate 46.7%. In a randomised controlled trial for individuals with a certain level of psychological distress, 420 participants were allocated to an intervention group and 416 to a control group. The dropout at 12-months follow-up was 22.4% in the intervention group and 13.9% in the control group. Results: There were no significant effects for individuals sick-listed with a psychiatric sick-leave diagnosis. For individuals without a psychiatric sick-leave diagnosis, significant effects were seen in the subscales of CMD-SQ (effect sizes: 0.20—0.28) and in more subscales of SF-36 (effect sizes: 0.12-0.22). The effects varied according to socio-demographic characteristics and somatic sick-leave diagnoses. Conclusion: The intervention was most effective for individuals without a psychiatric sick-leave diagnosis sick-listed from full-time work. Thus, despite small effect sizes, the intervention may be efficient for large subgroups on LSA.

Keywords

Epidemiology psychological distress quality of life randomised controlled trial sick-leave diagnosis socio-demographic characteristics undetected mental disorders

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