***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 : OBJECTIVE High levels of work-related stress are associated with increased absenteeism from work and reduced work ability . In this study , we investigated the effects of a stress management intervention on absenteeism and return to work . METHODS We r and omized 102 participants into either the intervention or wait-list control ( WLC ) group . The intervention group received the intervention in weeks 1 - 16 from baseline , and the WLC group received the intervention in weeks 17 - 32 . Self-reported data on absenteeism ( number of days full- or part-time absent from work within the previous three months ) were obtained at 16 , 32 , and 48 weeks follow-up . Register-based data on long-term absence from work were drawn from the Danish public transfer payments ( DREAM ) data base from baseline and 48 weeks onwards . The DREAM data base contains weekly information on long-term sickness absence compensation . The threshold to enter DREAM is sick leave for two consecutive weeks . RESULTS At follow-up in week 16 , self-reported absenteeism in the intervention group [ median 11 days ( range 3 - 25 ) ] was lower ( P=0.02 ) than in the WLC group [ median 45 days ( range 19 - 60 ) ] , corresponding to a 29 % [ 95 % confidence interval ( 95 % CI ) 5 - 52 ] reduction . On register-based data ( cumulated weeks in DREAM , weeks 1 - 16 ) , the intervention group median [ 6 weeks ( range 0 - 11 ) ] was lower than that of the WLC group [ median 12 weeks ( range 8 - 16 ) ] , though not significantly ( P=0.06 ) , corresponding to a 21 % ( 95 % CI 0 - 42 ) reduction . For return to work , a hazard ratio of 1.58 ( 95 % CI 0.89 - 2.81 ) favoring the intervention group was found ( P=0.12 ) . CONCLUSIONS The intervention reduces self-reported absenteeism from work . A similar trend was found from register-based records . No conclusive evidence was found for return to work 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 Background : Deficits in emotion regulation skills are possible factors maintaining major depressive disorder ( MDD ) . Therefore , the aim of the study was to test whether integrating a systematic emotion regulation training ( ERT ) enhances the efficacy of routine inpatient cognitive behavioral therapy ( CBT ) for MDD . Methods : In a prospect i ve r and omized controlled trial , 432 in patients meeting criteria for MDD were assigned to receive either routine CBT or CBT enriched with an intense emotion regulation skills training ( CBT-ERT ) . Results : Participants in the CBT-ERT condition demonstrated a significantly greater reduction in depression ( response rates - CBT : 75.5 % , CBT-ERT : 84.9 % ; remission rates - CBT : 51.1 % , CBT-ERT : 65.1 % ) . Moreover , CBT-ERT participants demonstrated a significantly greater reduction of negative affect , as well as a greater increase of well-being and emotion regulation skills particularly relevant for mental health . Conclusions : Integrating strategies that target emotion regulation skills improves the efficacy of CBT for MDD The aim of the current study was to test the effectiveness of ERP-based 12 weeks group therapy for OCD patients in a community-based , general Norwegian outpatient clinic . The sample consisted of 54 patients diagnosed with OCD . The Yale-Brown Obsessive-Compulsive Scale ( Y-BOCS ) , the Beck Depression Inventory ( BDI ) and the Spielberger State Anxiety Inventory ( STAI-S ) were administered before treatment , after treatment and at 3- and 12-month follow-ups . Analyses with mixed models for repeated measurements showed that group behavioural therapy offered to OCD patients significantly improved ratings of obsessive-compulsive symptoms , depression and anxiety . These improvements were maintained at 3- and 12-month follow-ups and an additional reduction in obsessive-compulsive symptoms was observed from post-treatment to 3-month follow-up . However , the delayed effect of therapy was no longer present at 12-month follow-up . The results also revealed that the patients had a lower chance for an increased outcome category ( e.g. from unchanged to improved or recovered ) with high scores on STAI-S at the given observation times ( post-treatment , 3- and 12-months follow-ups ) . Depressive symptoms ( BDI ) at post-treatment and follow-ups had no significant influences on the three categories of outcome for OCD . In conclusion , the results indicate that behavioural group therapy can successfully be delivered to patients with considerable comorbidity in a real world setting conducted by therapists with limited training in the CBT Work-related stress is widespread and can lead to long-term absenteeism and work disability . Cognitive-behavioral treatment ( CBT ) has demonstrated effectiveness in treating psychopathology but has only rarely been tested in clinical sample s with work-related stress . A r and omized controlled trial was conducted to investigate the efficacy of CBT-based stress management training ( SMT ) .  Eighty-two patients on sickness leave with work-related stress were r and omly assigned to ( a ) individual SMT , ( b ) group SMT , or ( c ) care as usual ( CAU ) . The SMT comprised 12 sessions conducted by a psychologist . Complaints of burnout and distress were measured at baseline , and at 4 , 7 , and 10 months . Absenteeism was measured during the whole research period . Across treatment conditions , complaints and sickness absence reduced considerably between baseline and 4 months . Thereafter , complaints remained approximately stable , whereas sickness absence further reduced . Hardly any significant group difference emerged , and no consistent pattern could be discerned in favor of any treatment condition . In subgroups with low depressive complaints , though , individual SMT result ed in larger reductions of some complaints than CAU . In conclusion , this study adds to the evidence that CBT-based interventions as currently practice d are not successful in treating patients with clinical levels of work-related stress BACKGROUND Sickness absence often occurs in patients with emotional distress or minor mental disorders . In several European countries , these patients are over-represented among those receiving illness benefits , and interventions are needed . The aim of this study was to evaluate the cost-effectiveness of an intervention conducted by social workers , design ed to reduce sick leave duration in patients absent from work owing to emotional distress or minor mental disorders . METHODS In this R and omized Controlled Trial , patients were recruited by GPs . The intervention group ( N = 98 ) received an activating , structured treatment by social workers , the  control group ( N = 96 ) received routine GP care .  Sick leave duration , clinical symptoms , and medical consumption ( consumption of medical staffs ' time as well as consumption of drugs ) were measured at baseline and 3 , 6 , and 18 months later . RESULTS Neither for sick leave duration nor for clinical improvement over time were significant differences found between the groups . Also the associated costs were not significantly lower in the intervention group . CONCLUSIONS Compared with usual GP care , the activating social work intervention was not superior in reducing sick leave duration , improving clinical symptoms , and decreasing medical consumption . It was also not cost-effective compared with GP routine care in the treatment of minor mental disorders . Therefore , further implementation of the intervention is not justified . Potentially , programmes aim ed at reducing sick leave duration in patients with minor mental disorders carried out closer to the workplace ( e.g. by occupational physicians ) are more successful than programmes in primary care Objectives To evaluate the cost effectiveness , cost utility and cost benefit of a workplace intervention compared with usual care for sick-listed employees with distress . Methods An economic evaluation was conducted alongside a r and omised controlled trial . Employees with distress and who were sick-listed for 2–8 weeks were r and omised to a workplace intervention ( n=73 ) or to usual care ( n=72 ) . The workplace intervention is a stepwise process involving the sick-listed employee and their supervisor , aim ed at formulating a consensus-based plan for return to work ( RTW ) . The effect outcomes were lasting RTW and quality -adjusted life years ( QALYs ) . Healthcare utilisation was measured over 12 months . Cost effectiveness analyses ( CEA ) and cost utility analyses ( CUA ) were conducted from the societal perspective and cost benefit analyses ( CBA ) from the employer perspective . Bootstrapping techniques were used to estimate cost and effect differences , related CIs , and cost effectiveness and cost utility ratios . Cost effectiveness planes were presented and subgroup analyses were performed . Results CEA and CUA revealed no statistically significant differences in lasting RTW , QALYs or costs . The CBA indicated a statistically significant higher cost of occupational health services in the workplace intervention group . The workplace intervention was not cost effective according to the CEA , CUA and CBA . Conclusions Widespread implementation of the workplace intervention for sick-listed employees with distress is not recommended because there was no economic benefit compared with usual care . Future trials should confirm if the workplace intervention is cost effective for the subgroup employees who intended to return to work despite symptoms . This trial has been registered at the Dutch National Trial Register IS RCT N92307123 Aims : To investigate the effectiveness of a worksite health promotion programme by individual counselling on sick leave . Methods : Three municipal services of Enschede , the Netherl and s , participated in this trial . A total of 299 civil servants were measured at baseline and were r and omised by cluster into the intervention ( n = 131 ) or the control group ( n = 168 ) . During nine months , subjects in the intervention group received a total of seven consultations , particularly aim ed at increasing their physical activity level and improving their dietary habits . Both the intervention and the control subjects received written information as to several lifestyle factors . Sick leave data regarding the nine month intervention period ( from May until January ) were collected from each municipal service ’s personnel department . In addition , sick leave data concerning the nine month period pre- and post-intervention were collected . Sick leave data were analysed using multilevel analysis . Results : For both groups , the mean sick leave rate during the intervention increased compared to before the intervention . After the intervention period , the control group increased even more ( from 22.9 to 27.6 days ) , whereas the intervention group slightly decreased ( from 21.5 to 20.5 days ) . Median values of sick leave rate decreased for both groups . No statistically significant intervention effect 
    Output:
    
Conclusions The combined study of sick-listed and non-sick-listed workers indicates occupational health services implement problem-solving treatment or CBT interventions , which can shorten total sick leave duration