Interventions to Facilitate Working While Depressed and Anxious

Study Overview
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Brief Summary
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The study compares the effects of two add-on interventions in primary care rehabilitation, on work ability and psychological health, in workers with common mental disorders. One intervention consists of a person-centered plan using work-directed treatment modules of occupational therapy and physical therapy, during 8 weeks. The other intervention consists of supported physical activity during 8 weeks. The primary outcome is work ability, measured by the work ability index and days on sick leave.

Detailed Description
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Common mental disorders (CMD), including mild to moderate depression, anxiety disorders and exhaustion disorder, are a major cause of sick leave and work disability. Compared to other disorders, work-related problems associated with CMD is sparsely explored. While recommended treatments, such as antidepressants or cognitive behavioral therapy have effects on psychiatric symptoms, the effect on work capacity is unclear, suggesting a need for alternative interventions. The aim of this study is to evaluate the effects of an add-on work-directed intervention in primary care rehabilitation, compared to a physical activity control, for persons with CMD. The goal of the experimental condition is to enhance the participant's ability to work by creating an individually tailored plan for self-management, supported by occupational and physical therapy techniques, such as structuring daily activities, stress management or body awareness techniques. Enhancing self-management is the core of this intervention and also a new approach compared to earlier efforts to promote work capacity.

Official Title
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Enhancing Work Ability in Common Mental Disorders: Comparing Two Interventions in Primary Care Rehabilitation

Conditions
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Work Capacity

Intervention / Treatment
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* Behavioral: Work-directed rehabilitation
* Behavioral: Physical activity


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unipolar depression or anxiety disorder according to the Mini Neuropsychiatric Interview (DSM-5 criteria). Currently working to some extent, part time sick leave is accepted. Exclusion Criteria: Substance abuse according to the Mini interview High suicide risk according to the Mini interview Psychotic symptoms according to the Mini interview

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Work-directed rehabilitation<br>Work-directed, person-centered plan using modules of occupational therapy and physical therapy | Behavioral: Work-directed rehabilitation<br>* Each participant starts with a meeting together with an occupational therapist or a physical therapist, focusing on the participant's resources and obstacles for functioning well at work. A plan is designed and carried out over 8 weeks, including 1-4 different treatment modules of occupational and physical therapy, to support the person's ability to function at work<br>|
| Active Comparator: Physical activity<br>Physical activity according to national health recommendations | Behavioral: Physical activity<br>* In a meeting with a physical therapist, each participant receives advice on physical activity to support mental health, according to national recommendations. The participant is offered to train at a local gym during 8 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Work ability | Work Ability Index | change in score from baseline to 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression severity | Montgomery Asberg Depression Rating Scale | change in score from baseline to 8 weeks | 
| Anxiety symptoms | Beck Anxiety Index | change in score from baseline to 8 weeks | 
| Mental wellbeing | WHO-5 Mental Wellbeing Index | change in score from baseline to 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Work capacity evaluation, Common mental disorders, Occupational therapy, Physical Therapy Modalities