De effectiviteit van een interventie door het maatschappelijk werk bij huisartspatiënten die overspannen zijn: Een gerandomiseerd vergelijkend onderzoek

Objective: To evaluate the effectiveness of an activating intervention designed to reduce sick leave duration in patients with emotional distress or minor mental disorders. Method: In an 18-month randomised controlled trial 194 patients with minor mental disorders received either an experimental intervention by social workers or usual GP care. The intervention focused on understanding causes, developing and implementing problem-solving strategies and early resumption of work. Outcome measures were duration of sick leave and mental and physical health (questionnaires included HADS, 4DSQ, and SF-36), all measured at baseline and 3, 6 and 18 months later. Results: The groups did not differ significantly on any of the outcome measures, except that the experimental group reported greater satisfaction with the treatment. In both groups, symptoms had decreased to normal levels around 3-6 months after baseline. The mean number of days until patients (partially) resumed work was 106 (SD 87) in the experimental and 121 (SD 94) in the control group. Conclusion: The intervention was not successful in reducing absenteeism duration in patients with emotional distress or minor mental disorders. Programmes aimed at reducing sick leave duration may yield better results if targeted on patients with more severe emotional problems than exclusively emotional distress or minor mental disorders, or if conducted by carers who are closer to the work environment than social workers, such as occupational physicians.