Guideline-based care of common mental disorders by occupational physicians (CO-OP study): a randomized controlled trial.
OBJECTIVE
To evaluate the effectiveness of guideline-based care (GBC) of workers with mental health problems, which promotes counseling by the occupational physician (OP) facilitating return to work (RTW).


METHODS
In a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240), trained OPs delivered GBC in the intervention group. Time to RTW and recurrences during 1-year follow-up, analyzed using Cox proportional hazards models, were compared with usual care (UC) with easy access to a psychologist.


RESULTS
GBC by OPs did not result in earlier RTW than UC. Subgroup analysis showed a small effect in favor of GBC for workers with administrative functions and/or "minor" stress-related symptoms.


CONCLUSIONS
GBC did not differ in RTW compared with UC, but may be beneficial for the majority of workers with minor stress-related disorders.
Rebergen
D S
DS
Departments of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
Bruinvels
D J
DJ
Bezemer
P D
PD
van der Beek
A J
AJ
van Mechelen
W
W
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009426:Netherlands; D016272:Occupational Health; D017063:Outcome Assessment, Health Care; D016495:Police; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D011584:Psychology; D018582:Sick Leave