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首页> 外文期刊>Occupational and environmental medicine >Collaborative care for sick-listed workers with major depressive disorder: A randomised controlled trial from the netherlands depression initiative aimed at return to work and depressive symptoms
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Collaborative care for sick-listed workers with major depressive disorder: A randomised controlled trial from the netherlands depression initiative aimed at return to work and depressive symptoms

机译：对患有重度抑郁症的列名病患者的协作医疗：荷兰抑郁症倡议的一项随机对照试验，旨在恢复工作和抑郁症状

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Objectives Major depressive disorder (MDD) is associated with absenteeism. In this study, the effectiveness of collaborative care, with a focus on return to work (RTW), was evaluated in its effect on depressive symptoms and the duration until RTW in sick-listed workers with MDD in the occupational health setting. Methods In this randomised controlled trial, 126 sicklisted workers with MDD were randomised to usual care (N=61) or collaborative care (N=65). Collaborative care was applied by the occupational physician care manager, supported by a web-based tracking system and a consultant psychiatrist. Primary outcome measure was time to response. Secondary outcome measures were time to remission, depressive symptoms as continuous measure and the duration until full RTW. Results Collaborative care participants had a shorter time to response, with a difference of 2.8 months. However, no difference was found on time to remission or depressive symptoms as continuous measure. With a mean of 190 days in the collaborative care group, and 210 days in the usual care group, the groups did not differ significantly from each other in the duration until full RTW. Adherence to the collaborative care intervention was low. Conclusions These results do not justify a widespread implementation of collaborative care in occupational healthcare, as it was operationalised in this study. However, since the study might have been underpowered for RTW and because treatment integrity was low, further research, with larger sample sizes, is needed to develop the best fitting (collaborative care) model for addressing RTW in depressed sick-listed workers.
机译：目的重度抑郁症（MDD）与旷工有关。在这项研究中，评估了在重返工作岗位（RTW）的情况下，合作医疗对抑郁症状的影响以及在职业健康环境中患有MDD的患病列出的工人接受RTW之前的持续时间。方法在这项随机对照试验中，将126名患MDD的病历工人随机分为常规护理（N = 61）或协作护理（N = 65）。协作式护理由职业医师护理经理实施，并由基于Web的跟踪系统和心理医生顾问提供支持。主要结局指标是反应时间。次要结果指标为缓解时间，抑郁症状为连续指标以及直至完全RTW的持续时间。结果协作护理参与者的响应时间较短，相差2.8个月。然而，在缓解或抑郁症状的持续时间方面，未发现差异。在协作护理组中平均为190天，在常规护理组中为210天，在完全RTW之前，两组之间的持续时间没有显着差异。对合作医疗干预的依从性很低。结论这些结果并不能证明在本研究中实施了合作医疗在职业医疗中的广泛实施。但是，由于该研究可能对RTW的处理能力不足，并且由于治疗的完整性低，因此需要进一步的研究，以更大的样本量来开发最佳拟合（协作护理）模型，以解决抑郁症患者中的RTW。

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