title: Symptom reduction due to psychosocial interventions is not accompanied by a reduction in sick leave: results from a randomized controlled trial in primary care.
abstract: OBJECTIVE
  To investigate whether interventions that have positive effects on psychological symptoms and quality of life compared with usual care would also reduce days on sick leave.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  A large primary health care centre in Stockholm, Sweden. Intervention. Patients with common mental disorders were recruited by their GPs and randomized into one of two group interventions that took place in addition to usual care. These group interventions were: (a) group cognitive behavioural therapy (CBT), and (b) group multimodal intervention (MMI). Both types of intervention had previously shown significant effects on quality of life, and MMI had also shown significant effects on psychological symptoms.
  
  
  METHODS
  Of the 245 randomized patients, 164 were employed and had taken sick leave periods of at least two weeks in length during the study period of two years. They comprised the study group.
  
  
  METHODS
  The odds, compared with usual care, for being sick-listed at different times relative to the date of randomization.
  
  
  RESULTS
  The mean number of days on sick leave increased steadily in the two years before randomization and decreased in the two years afterwards, showing the same pattern for all three groups .The CBT and MMI interventions did not show the expected lower odds for sick-listing compared with usual care during the two-year follow-up.
  
  
  CONCLUSIONS
  Reduction in psychological symptoms and increased well-being did not seem to be enough to reduce sickness absence for patients with common mental problems in primary care. The possibility of adding workplace-oriented interventions is discussed.
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden.
authors.forename: Kersti
authors.initials: K
authors.lastname: Ejeby
authors.forename: Ruslan
authors.initials: R
authors.lastname: Savitskij
authors.forename: Lars-Göran
authors.initials: LG
authors.lastname: Ost
authors.forename: Anders
authors.initials: A
authors.lastname: Ekbom
authors.forename: Lena
authors.initials: L
authors.lastname: Brandt
authors.forename: Jonas
authors.initials: J
authors.lastname: Ramnerö
authors.forename: Marie
authors.initials: M
authors.lastname: Asberg
authors.forename: Lars G
authors.initials: LG
authors.lastname: Backlund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden; D055815:Young Adult
keywords: General practice; Sweden; group psychotherapy; primary health care; psychological symptoms; psychosocial interventions; randomized controlled trial; sick leave
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