Revisión Sistemática - Intervenciones en el proceso de Retorno al Trabajo en los Trastornos Mentales Comunes

Autores/as

  • Gaetano Pepe Betancourt Instituto de Salud Carlos III, Escuela Nacional de Medicina del Trabajo, Madrid
  • Ana Cristina Brand P Sante Fe College of Gainesville, Florida

DOI:

https://doi.org/10.4321/s0465-546x2021000300006

Palabras clave:

Salud mental; absentismo; costos de atención en salud; retorno al trabajo

Resumen

Introducción: Los trastornos mentales comunes (TMC), causan sufrimiento individual y menoscabo significativo a la salud, tienen un impacto negativo en el bienestar del individuo, las circunstancias financieras y a la sociedad. La respuesta de los médicos ha sido otorgar la incapacidad con la finalidad de mitigar los síntomas. Pero el dilema que entraña esta respuesta es que el reposo es beneficioso sólo si mantiene un equilibrio funcional del paciente y el retorno al trabajo. Bajo este enfoque, se plantea que las intervenciones psicosociales permiten preparar al individuo para retornar al trabajo. 

Método: el diseño de esta revisión es de alcance descriptivo y de enfoque mixto. La búsqueda se realizó a partir de: PubMed/MEDLINE, ELSEVIER, SciELO, Academic Google. El criterio de temporalidad fueron artículos publicados en los últimos 5 años, desde el 06 de diciembre y finalizo el 30 de diciembre del 2019.

Resultados: se analizaron 28 artículos a texto completo, la evidencia científica se sustentó en 13 estudios controlados. Se encontró evidencia de calidad moderada de que las intervenciones aplicadas mejoran los síntomas y reducen el número de días de incapacidad en pacientes con TMC. Nivel de evidencia B de GRADE.

Conclusiones: las intervenciones psicosociales facilitan un retorno al trabajo saludable y sostenible. Sin embargo, para que esto suceda, estas deben dirigirse no solo al individuo con incapacidad para trabajar, sino también a la interacción de este con su lugar de trabajo.

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Citas

Garrido-Larrea P, Ansoleaga-Moreno E, Tomicic-Suñer A, Domínguez-Valverde C, Castillo-Vergara S, Lucero-Chenevard C, et al. Afecciones de Salud Mental y el Proceso de Retorno al Trabajo: Una Revisión Sistemática. Cienc Trab. 2013;15(48):105-13. DOI: 10.4067/S0718-24492013000300002. Disponible en: https://bit.ly/3Iey1XD

Stuart, H. Stigmatisation et discrimination liées à la santé mentale en milieu de travail. En: Corbière M, Durand MJ. Du trouble mental à l’incapacité au travail. Québec: Presses de l’Université du Québec; 2011. p. 367-91. ISBN: 978-2-7605-2547-4.

Roeloffs C, Sherbourne C, Unützer J, Fink A, Tang L, Wells KB. Stigma and depression among primary care patients. Gen Hosp Psychiatry. 2003;25(5):311-5. DOI: 10.1016/S0163-8343(03)00066-5. Disponible en: https://bit.ly/32XJGtR

Finnes A, Enebrink P, Ghaderi A, Dahl J, Nager A, Öst LG. Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials. Int Arch Occup Environ Health. 2019;92(3):273–93. DOI: 10.1007/s00420-018-1380-x. Disponible en: https://bit.ly/3lRLmvJ

World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. WHO/MSD/MER/2017.2. Disponible en: https://bit.ly/3rxR6y4

Urrutia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clin (Barc). 2010;135(11):507–11. DOI: 10.1016/j.medcli.2010.01.015. Disponible en: https://bit.ly/3ddPOQw

Haslam C, Atkinson S, Brown S, Haslam R. Perceptions of the impact of depression and anxiety and the medication for these conditions on safety in the workplace. Occup Environ Med. 2005;62(8):538-45. DOI: 10.1136/oem.2004.016196. Disponible en: https://oem.bmj.com/content/62/8/538

Dewa CS, Lin E. Chronic physical illness, psychiatric disorder and disability in the workplace. Soc Sci Med. 2000;51(1):41-50. DOI: 10.1016/s0277-9536(99)00431-1. Disponible en: https://bit.ly/3ppOLTm

Bellmann L, Hilpert M, Kistler E, Wahse J. Herausforderungen des demografischen Wandels für den Arbeitsmarkt und die Betriebe. In: Mitteilungen aus der Arbeitsmarkt- und Berufsforschung. Erscheinungsjahr; 2003;36(2). p. 133-49. Disponible en: https://bit.ly/3ryjwIu

Gabbay M, Taylor L, Sheppard L, Hillage J, Bambra C, Ford F, et al. NICE guidance on long-term sickness and incapacity. Br J Gen Pract. 2011;61(584):e118-24. DOI: 10.3399/bjgp11X561221. Disponible en: https://bjgp.org/content/61/584/e118

Hoefsmit N, Houkes I, Nijhuis F. Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review. J Occup Rehabil. 2012;22(4):462-77. DOI: 10.1007/s10926-012-9359-z. Disponible en: https://bit.ly/3rwf50F

Persson J, Bernfort L, Wåhlin C, Öberg B, Ekberg K. Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden. Disabil Rehabil. 2015;37(9):771-6. DOI: 10.3109/09638288.2014.941021. Disponible en: https://bit.ly/3pGxTrJ

Mattias V, Bjørn L, Torleif R. Predictors of return to work among patients in treatment for common mental disorders: a pre-post study. BMC Public Health. 2017;18(1):27. DOI: 10.1186/s12889-017-4581-4. Disponible en: https://bit.ly/3dg7drP

Lagerveld SE, Blonk RWB, Brenninkmeijer V, Wijngaards-de Meij L, Schaufeli WB. Work-focused treatment of common mental disorders and return to work: a comparative outcome study. J Occup Health Psychol. 2012;17(2):220-34. DOI: 10.1037/a0027049. Disponible en: https://bit.ly/3El5P3b

Arends I, Bruinvels DJ, Rebergen DS, Nieuwenhuijsen K, Madan I, Neumeyer-Gromen A, et al. Interventions to facilitate return to work in adults with adjustment disorders. Cochrane Database Syst Rev. 2012;12:CD006389. DOI: 10.1002/14651858.CD006389.pub2. Disponible en: https://bit.ly/3DlGAMO

Hees HL, Koeter MWJ, Schene AH. Predictors of long-term return to work and symptom remission in sick-listed patients with major depression. J Clin Psychiatry. 2012;73(8):e1048-55. DOI: 10.4088/JCP.12m07699. Disponible en: https://bit.ly/3ILEEAZ

Nigatu YT, Liu Y, Uppal M, McKinney S, Rao S, Gillis K, et al. Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials. Psychol Med. 2016;46(16):3263-74. DOI: 10.1017/S0033291716002269. Disponible en: https://bit.ly/3yrpoVq

Brämberg EB, Holmgren K, Bültmann U, Gyllensten H, Hagberg J, Sandman L, et al. Increasing return-to-work among people on sick leave due to common mental disorders: design of a cluster-randomized controlled trial of a problem-solving intervention versus care-as-usual conducted in the Swedish primary health care system (PROSA). BMC Public Health. 2018;18(1):889. DOI: 10.1186/s12889-018-5816-8. Disponible en: https://bit.ly/3oTNLHY

Sylvain C, Durand MJ. Supporting the return to work following sick leave for a depressive disorder: why and how. Sante Ment Que. 2017;42(1):305-18. PMID: 28792574

van der Feltz-Cornelis CM, Hoedeman R, de Jong FJ, Meeuwissen JAC, Drews HW, van der Laan NC, et al. Faster return to work after psychiatric consultation for sicklisted employees with common mental disorders compared to care as usual, A randomized clinical trial. Neuropsychiatr Dis Treat. 2010;7(6):375-85. DOI: 10.2147/ndt.s11832. Disponible en: https://bit.ly/3DY4XAd

Rebergen DS, Bruinvels DJ, van Tulder MW, van der Beek AJ, van Mechelen W. Cost effectiveness of guideline-based care for workers with mental health problems. J Occup Environ Med. 2009;51(3):313-22. DOI: 10.1097/JOM.0b013e3181990d8e. Disponible en: https://bit.ly/3GY1Avp

World Health Organisation. International classification of diseases and related health problems: ICD-10. Genève, Suisse; 2019. Disponible en: https://icd.who.int/browse10/2019/en#/I

Wade AG, Fernandez JL, Francois C, Hansen K, Danchenko N, Despiegel N. Escitalopram and duloxetine in major depressive disorder: a pharmacoeconomic comparison using UK cost data. Pharmacoeconomics. 2008;26(11):969-81. DOI: 10.2165/00019053-200826110-00008. Disponible en: https://bit.ly/3IMIXw2

van der Feltz-Cornelis CM, Hoedeman R, de Jong FJ, Meeuwissen JAC, Drewes HW, van der Laan NC, et al. Faster return to work after psychiatric consultation for sicklisted employees with common mental disorders compared to care as usual, a randomized clinical trial. Neuropsychiatr Dis Treat. 2010;6(6):375-85. DOI: 10.2147/ndt.s11832. Disponible en: https://bit.ly/3DY4XAd

Nieuwenhuijsen K, Noordik E, van Dijk FJH, van der Klink JJ. Return to work perceptions and actual return to work in workers with common mental disorders. J Occup Rehabil. 2013;23(2):290-9. DOI: 10.1007/s10926-012-9389-6. Disponible en: https://bit.ly/3GKV4HV

Volker D, Zijlstra-Vlasveld MC, Brouwers EPM, van Lomwel AGC, van der Feltz-Cornelis CM. Return-to-work self-efficacy and actual return to work among long-term sick-listed employees. J Occup Rehabil. 2015;25(2):423-31. DOI: 10.1007/s10926-014-9552-3. Disponible en: https://bit.ly/30oerHo

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13. DOI: 10.1046/j.1525-1497.2001.016009606.x. Disponible en: https://bit.ly/3E0fT0A

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. Disponible en: https://bit.ly/3m6iqjt

Poulsen R, Hoff A, Fisker JP, Hjorthoj C, Eplov LF. Study Protocol: Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of common mental disorders (IBBIS). Regional Ethics committee: H-16015724. Version 3.1: July 5th 2019

Dewa CS, Hoch JS. Estimating the net benefit of a specialized return-to-work program for workers on short-term disability related to a mental disorder: an example exploring investment in collaborative care. J Occup Environ Med. 2014 jun;56(6):628-31. DOI: 10.1097/JOM.0000000000000157. Disponible en: https://bit.ly/3IKma3U

Volker D, Zijlstra-Vlasveld MC, Anema JR, Beekman ATF, Brouwers EPM, Emons WHM, et al. Effectiveness of a blended web-based intervention on return to work for sick-listed employees with common mental disorders: results of a cluster randomized controlled trial. J Med Internet Res. 2015;17(5):e116. DOI: 10.2196/jmir.4097. Disponible en: https://www.jmir.org/2015/5/e116/

Arends I, van der Klink JJL, van Rhenen W, de Boer MR, Bültmann. Prevention of recurrent sickness absence in workers with common mental disorders: results of a cluster-randomised controlled trial. Occup Environ Med. 2014;71(1):21-9. DOI: 10.1136/oemed-2013-101412. Disponible en: https://oem.bmj.com/content/71/1/21

Volker D, Vlasveld MC, Anema JR, Beekman AF, van Roijen LH, Brouwers EPM, et all. Blended E-health module on return to work embedded in collaborative occupational health care for common mental disorders: design of a cluster randomized controlled trial. Neuropsychiatr Dis Treat. 2013;9:529-37. DOI: 10.2147/NDT.S43969. Disponible en: https://bit.ly/31NZf7j

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13. DOI: 10.1046/j.1525-1497.2001.016009606.x. Disponible en: https://bit.ly/3E0fT0A

Lokman S, Volker D, Zijlstra-Vlasveld MD, Brouwers EPM, Boon B, Beekman ATF, et al. Return-to-work intervention versus usual care for sick-listed employees: health-economic investment appraisal alongside a cluster randomised trial. BMJ Open. 2017;7(10). DOI: 10.1136/bmjopen-2017-016348. Disponible en: https://bmjopen.bmj.com/content/7/10/e016348

Waddell G, Burton AK. Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med (Lond). 2001;51(2):124-35. DOI: 10.1093/occmed/51.2.124. Disponible en: https://bit.ly/31ZSO0H

Tompa E, de Oliveira C, Dolinschi R, Irvin E. A systematic review of disability management interventions with economic evaluations. J Occup Rehabil. 2008;18(1):16-26. DOI: 10.1007/s10926-007-9116-x. Disponible en: https://bit.ly/3yrxa1y

Carroll C, Rick J, Pilgrim H, Cameron J, Hillage J. Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil. 2010;32(8):607-21. DOI: 10.3109/09638280903186301. Disponible en: https://bit.ly/3s5MOhW

Office for Official Publications of the European Communities. Work-related musculoskeletal disorders: Back to work report. EU-OSHA. 2007. Disponible en: https://bit.ly/3dQPFms

Sampson A. Interventions to improve return to work outcomes in individuals with mental health conditions. Institute for Safety, Compensation and Recovery Research. Research report. 2015:152-0615-R01. Disponible en: https://bit.ly/3yry1iM

Wang PS, Simon SE, Avorn J, Axocar F, Ludman EJ, McCulloch J, et al. Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. JAMA. 2007;298(12):1401-11. DOI: 10.1001/jama.298.12.1401. Disponible en: https://bit.ly/3dVRmih

van Beurden KM, Brouwers EPM, Joosen MCT, Terluin B, van der Klink JJK, van Weeghel J. Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial. BMC Public Health. 2013;13:193. DOI: 10.1186/1471-2458-13-193. Disponible en: https://bit.ly/3m4rJR0

Leka S, Jain A, Houtman I, McDaid D, Park A, de Boreck V, et al. Evaluation of policy and practice to promote mental health in the workplace in Europe, Final Report. Employment, Social Affairs & Inclusion European Commission. 2014.

Nieuwenhuijsen K, Faber B, Verbeek JH, Neumeyer-Gromen A, Hees HL, Verhoeven AC, et al. Interventions to improve return to work in depressed people. Cochrane Database Syst Rev. 2014;(12):CD006237. DOI: 10.1002/14651858.CD006237.pub3. Disponible en: https://bit.ly/3dRAvx7

Olsson D, Alexanderson K, Bottai M. What positive encounters with healthcare and social insurance staff promotes ability to return to work of long-term sickness absentees?. Scand J Public Health. 2016;44(1):91-7. Disponible en: https://www.jstor.org/stable/48512627

Dewa C, Loong D, Bonato S, Joosen MCW. The effectiveness of return-to-work interventions that incorporate work-focused problem-solving skills for workers with sickness absences: a systematic literature review. BMJ Open. 2015;5(6):e007122. DOI: 10.1136/bmjopen-2014-007122. Disponible en: https://bmjopen.bmj.com/content/5/6/e007122

Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijper P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry. 2016;3(5):415-24. DOI: 10.1016/S2215-0366(16)30024-4. Disponible en: https://bit.ly/31O4wf7

Šrekl J. Reducing Absenteeism and a Faster Return to Work. Social sciences. 2017;6(6):141-7. Disponible en: https://bit.ly/3GJ3ccg

Pomaki G. Return-to-Work Strategies for Employees with Mental Health Condition. Benefits Q. 2017;33(1):50-5. PMID: 29465187

Momsen AH, Stapelfeldt CM, Nielsen CV, Nielsen MBD, Rugulies R, Jensen C. Screening instruments for predicting return to work in long-term sickness absence. Occup Med (Lond). 2017;67(2):101-8. DOI: 10.1093/occmed/kqw093. Disponible en: https://bit.ly/3DV90gW

Joosen M, Arends I, Lugtenberg M, van Gestel HJ, Schaapveld B, Terluin B, et al. Barriers to and facilitators of return to work after sick leave in workers with common mental disorders. Tilburg University, Tilburg School of Social and Behavioral Sciences, Department Tranzo, Warandelaan 2, 5037 AB Tilburg, The Netherlands. 2017. Disponible en: https://bit.ly/3s8X88G

Brämberg EB, Holmgren K, Bültmann U, Gyllensten H, Hagberg J, Sandman L, et al. Increasing return-to-work among people on sick leave due to common mental disorders: design of a cluster-randomized controlled trial of a problem-solving intervention versus care-as-usual conducted in the Swedish primary health care system (PROSA). BMC Public Health. 2018;18(1):889. DOI: 10.1186/s12889-018-5816-8. Disponible en: https://bit.ly/3oTNLHY

Vries H, Fishta A, Weikert B, Rodríguez-Sánchez A, Wegewitz U. Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review. J Occup Rehabil. 2018;28(3):393-417. DOI: 10.1007/s10926-017-9730-1. Disponible en: https://bit.ly/3DT9Tq8

Goorts K, Vandenbroeck S, Vander Elst T, Rusu D, Du Bois M, Decuman S, et al. Quickscan assesses risk factors of long-term sickness absence: A cross-sectional (factorial) construct validation study. PLoS One. 2019;14(1):e0210359. DOI: 10.1371/journal.pone.0210359. Disponible en: https://bit.ly/3dLU36h

Finnes A, Enebrink P, Ghaderi A, Dahl J, Nager A, Öst LG. Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials. Int Arch Occup Environ Health. 2019;92(3):273-93. DOI: 10.1007/s00420-018-1380-x. Disponible en: https://bit.ly/3lRLmvJ

Johnston DA, Harvey SB, Glozier N, Calvo RA, Christensen H, Deady M. The relationship between depression symptoms, absenteeism and presenteeism. J Affect Disord. 2019;256:536-40. DOI: 10.1016/j.jad.2019.06.041. Disponible en: https://bit.ly/3ETElSr

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Publicado

25-02-2022

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1.
Betancourt GP, Brand P AC. Revisión Sistemática - Intervenciones en el proceso de Retorno al Trabajo en los Trastornos Mentales Comunes. Med Segur Trab [Internet]. 25 de febrero de 2022 [citado 27 de julio de 2024];67(264):212-31. Disponible en: //revista.isciii.es/index.php/MST/article/view/1187

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