***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction Return to work ( RTW ) of employees on sick leave for common mental disorders may require a multidisciplinary approach . This article aims to assess time to RTW after a psychiatric consultation providing treatment advice to the occupational physician ( OP ) for employees on sick leave for common mental disorders in the occupational health ( OH ) setting , compared to care as usual ( CAU ) . Methods Cluster r and omized clinical trial evaluating patients of 12 OPs receiving consultation by a psychiatrist , compared to CAU delivered by 12 OPs in the control group . 60 patients suffering from common mental disorders and ≥ six weeks sicklisted were included . Follow up three and six months after inclusion . Primary outcome measure was time to RTW . Intention- to-treat multilevel analysis and a survival analysis were performed to evaluate time to RTW in both groups . Results In CAU , referral was the main intervention . Both groups improved in terms of symptom severity and quality of life , but time to RTW was significantly shorter in the psychiatric consultation group . At three months follow up , 58 % of the psychiatric consultation group had full RTW versus 44 % of the control group , a significant finding ( P = 0.0093 ) . Survival analysis showed 68 days earlier RTW after intervention in the psychiatric consultation group ( P = 0.078 ) compared to CAU . Conclusion Psychiatric consultation for employees on sick leave in the OH setting improves time to RTW in patients with common mental disorders as compared to CAU . In further research , focus should be on early intervention in patients with common mental disorders on short sick leave duration  . Psychiatric consultation might be particularly promising for improvement of RTW in those patients . Trial registration number IS RCT N : Background Since a higher level of self-efficacy in common mental disorders is associated with earlier return-to-work ( RTW ) , it is important to know if work related self-efficacy can be increased by occupational health care . The primary aim of this study was to evaluate whether an intervention to enhance guideline adherence of occupational physicians lead to an increase in RTW self-efficacy in workers three months later . The secondary aim was to evaluate whether the intervention modified the association between RTW self-efficacy and return-to-work three months later . Methods A total of 66 occupational physicians participated in the study . They were r and omized into two groups ; the intervention group received a training , the control group did not . The training aim ed to enhance adherence to a mental health guideline that contained strategies that are supposed to enhance RTW self-efficacy . In 128 sick-listed workers guided by these occupational physicians , RTW self-efficacy , RTW , and personal , health-related and work-related variables were measured at baseline and three months later . Generalized linear mixed models analysis and linear mixed models analysis were used for the evaluations . Results In workers whose occupational physicians had received the training RTW self-efficacy increased significantly more than in workers whose occupational physicians had participated in the control group ( t = −2.626 , p ≤ .05 ) . Higher baseline RTW self-efficacy scores were significantly more often associated with full RTW than with no RTW three months later ( OR 2.20 , 95 % CI 1.18–4.07 ) , but the intervention did not affect this association . Conclusions This study showed that a training to enhance guideline adherence of occupational physicians leads to increased RTW self-efficacy in workers sick-listed with common mental disorders during the first months of sickness absence in a real-life occupational health care setting . This insight is helpful for optimizing the recovery and RTW process , and for underst and ing the role of RTW self-efficacy in this process . Trial registration IS RCT Purpose Evidence -based guidelines in occupational health care improve the quality of care and may reduce sickness absence duration . Notwithst and ing that , guideline adherence of occupational physicians ( OPs ) is limited . Based on the literature on guideline implementation , an intervention was developed that was shown to effectively improve self-reported adherence in OPs . The aim of present study was to evaluate whether this intervention leads to earlier return to work ( RTW ) in workers with common mental disorders ( CMD ) . Methods In a two-armed cluster r and omized controlled trial , 66 OPs were r and omized . The trial included 3379 workers , with 1493 in the intervention group and 1886 in the control group . The outcome measures were : time to full RTW , time to first RTW , and total hours of sickness absence . Cox regression analyses and generalized linear mixed model analyses were used for the evaluations . Results The median time to RTW was 154 days among the 3228 workers with CMD . No significant differences occurred in ( time to ) full RTW between intervention and control group HR 0.96 ( 95 % CI 0.81–1.15 ) nor for first RTW HR 0.96 ( 95 % CI 0.80–1.15 ) . The mean total hours of sickness absence was 478 h in the intervention group and 483 h in the control group . Conclusions The intervention to enhance OPs ’ guideline adherence did not lead to earlier RTW in workers with CMD guided by the OPs . Possible explanations are the remaining external barriers for guideline use , and that perceived guideline adherence might not represent actual guideline adherence and improved care . Trail registration : IS RCT N86605310 R and omised controlled trial to evaluate the effectiveness of collaborative care in a Dutch occupational healthcare setting : 126 workers on sick leave with major depressive disorder were r and omised to usual care ( n = 61 ) or collaborative care ( n = 65 ) . After 3 months , collaborative care was more effective on the primary outcome measure of treatment response ( i.e. reduction in symptoms of ≥50 % ) on the Patient Health Question naire-9 ( PHQ-9 ) . However , the groups did not differ on the PHQ-9 as a continuous outcome measure . Implication s of these results are discussed Objective To examine the efficacy of structured early consultation among employees at high risk for future long-term sickness absence , in the prevention and /or reduction of sickness absence . The focus of the experiment was the timing of the intervention , that is , treatment before sickness absence actually occurs . Methods In the current prospect i ve r and omized controlled trial ( RCT ) , employees at high risk for long-term sickness absence were selected based on responses to a 34-item screening question naire including demographic , workplace , health and psychosocial factors associated with long-term sickness absence ( > 28 days ) . A total of 299 subjects at risk for future long-term sickness absence were r and omized in an experimental group ( n = 147 ) or in a control group ( n = 152 ) . Subjects in the experimental group received a structured early consult with their occupational physician ( OP ) , in some cases followed by targeted intervention . The control group received care as usual .  Sickness absence was assessed objective ly through record linkage with the company registers on sickness absence over a 1 year follow-up period . Results Modified intention-to-treat analysis revealed substantial and statistically significant differences ( p = 0.007 ) in total sickness absence duration over 1 year follow-up between the experimental ( mean 18.98 ; SD 29.50 ) and control group ( mean 31.13 ; SD 55.47 ) . Per- protocol analysis additionally showed that the proportion of long-term sickness absence spells ( > 28 days ) over 1 year follow-up was significantly ( p = 0.048 ) lower in the experimental ( 9.1 % ) versus control group ( 18.3 % ) . Conclusions Structured early consultation with the OP among employees at high risk for future long-term sickness absence is successful in reducing total sickness absence OBJECTIVE The aim of the present study was to compare the effectiveness and acceptability of three interventions for occupational stress . METHODS / DESIGN A total of 90 National Health Service employees were r and omized to face-to-face counselling or telephone counselling or bibliotherapy . Outcomes were assessed at post-intervention and 4-month follow-up . Clinical Outcomes in Routine Evaluation ( CORE ) , General Health Question naire ( GHQ-12 ) , and Perceived Stress Scale ( PSS-10 ) were used to evaluate intervention outcomes . An intention-to-treat analyses was performed . RESULTS Repeated measures analysis revealed significant time effects on all measures with the exception of CORE Risk . No significant group effects were detected on all outcome measures . No time by group significant interaction effects were detected on any of the outcome measures with the exception of CORE Functioning and GHQ total . With regard to acceptability of interventions , participants expressed a preference for face-to-face counselling over the other two modalities . CONCLUSIONS Overall , it was concluded that the three intervention groups are equally effective . Given that bibliotherapy is the least costly of the three , results from the present study might be considered in relation to a stepped care approach to occupational stress management with bibliotherapy as the first line of intervention , followed by telephone and face-to-face counselling as required AIM This paper is a report of a study to test the effect of participating in a reflecting peer-support group on self-reported health , burnout and on perceived changes in work conditions . BACKGROUND Stress-related conditions are one of the most common causes for long-term sick-leave . There is limited evidence for the effectiveness of person-directed interventions aim ed at reducing stress levels in healthcare workers . Prior research in the relationship between support and burnout show somewhat inconsistent results . METHOD A r and omized controlled trial with peer-support groups as the intervention was conducted with 660 healthcare workers scoring above the 75th percentile on the exhaustion dimension of the Oldenburg Burnout Inventory . One hundred and fifty-one ( 22.9 % ) agreed to participate . The intervention started in 2002 with 51 participants ( 96.1 % were women ) , 80 of whom constituted the control group .  Potential differences in outcome measures 12 months after the intervention were compared using ancova , and data collected was completed in 2004 . Qualitative content analyses were used to analyse reported experiences from group participation . RESULTS Statistically significant intervention effects were found for general health , perceived quantitative dem and s at work , participation and development opportunities at work and in support at work . Seven categories of experiences from participating were identified : talking to others in a similar situation , knowledge , sense of belonging , self-confidence , structure , relief of symptoms and behavioural change . CONCLUSION Peer-support groups using a problem-based method could be a useful and comparatively inexpensive tool in alleviating work-related stress and burnout OBJECTIVES Nurses are at elevated risk of burnout , anxiety and depressive disorders , and may then become less productive . This begs the question if a preventive intervention in the work setting might be cost-saving from a business perspective . MATERIAL AND METHODS A cost-benefit analysis was conducted to evaluate the balance between the costs of a  preventive intervention among nurses at elevated risk of mental health complaints and the cost offsets stemming from improved productivity . This evaluation was conducted alongside a cluster-r and omized trial in a Dutch academic hospital . The control condition consisted of screening without feedback and unrestricted access to usual care  ( N = 206 ) . In the experimental condition screen-positive nurses received personalized feedback and referral to the occupational physician ( N = 207 ) . RESULTS Subtracting intervention costs from the cost offsets due to reduced absenteeism and presenteeism result ed in net-savings of 244 euros per nurse when only absenteeism is regarded , and 651 euros when presenteeism is also taken into account . This corresponds to a return-on-investment of 5 euros up to 11 euros for every euro invested . CONCLUSIONS Within half a year , the cost of offering the preventive intervention was more than recouped . Offering the preventive intervention represents a favorable business case as seen from the employer 's perspective Objectives The aim of the present study was to investigate whether participation in a structured re source -enhancing group intervention at work would act as primary prevention against depression . The authors analysed whether the intervention result ed in universal , selected or indicated prevention . Methods A total of 566 persons participated in a prospect i ve , within-organisation , r and omly assigned field experimental study , which consisted of 34 workshops in 17 organisations . The participants filled in a question naire , were r and omly assigned to either intervention ( n=296 ) or comparison ( n=324 ) groups and returned another question naire 7 months later . The intervention , lasting four half-day sessions , was delivered by trainers from occupational health services and human re sources . The aim of the structured programme was to enhance participants ' career management preparedness by strengthening self-efficacy and inoculation against setbacks . The comparison group received a literature package . The authors measured depressive symptoms using the short version of the Beck Depression Inventory . A high number of depressive symptoms ( over 9 points ) were used as a proxy for depression . Results At follow-up , the odds of depression were lower in the intervention group ( OR=0.40 , 95 % CI 0.19 to 0.85 ) than in the comparison group when adjusted for baseline depressive symptoms , job strain and socio-demographics . In addition , the odds of depression among those with job strain ( OR=0.15 , 95 % CI 0.03–0.81 ) at baseline were lower after the intervention . The intervention had no statistically significant effect on those with depressive symptoms ( over 4 points ) at baseline . Conclusion The re source -enhancing group intervention appeared to be successful as universal and selective prevention of potential depression OBJECTIVES In case of long-term sick leave , gradually increasing workload appears to be an effective component of work-directed interventions to reduce sick leave due to common mental disorders ( CMD ) . CMD are defined as stress-related , adjustment , 
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However , effect on return to full-time work was not consistent , and these interventions did not consistently improve CMD symptoms .
Interventions at the workplace/organizational level were less common .
Return-to-work and improvement of CMD symptoms are poorly correlated and should be addressed simultaneously in future interventions .