Guideline-based care of common mental disorders by occupational physicians (CO-OP study): a randomized controlled trial.

Abstract

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). 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. 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. GBC did not differ in RTW compared with UC, but may be beneficial for the majority of workers with minor stress-related disorders.