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van der Feltz-Cornelis CM, Shepherd J, Gevaert J, Van Aerden K, Vanroelen C, Cepa OB, Recio LG, Bernard RM, Vorstenbosch E, Cristóbal-Narváez P, Felez-Nobrega M, de Miquel C, Merecz-Kot D, Staszewska K, Sinokki M, Naumanen P, Roijen LHV, van Krugten F, de Mul M, Haro JM, Olaya B. Design and development of a digital intervention for workplace stress and mental health (EMPOWER). Internet Interv 2023; 34:100689. [PMID: 38054076 PMCID: PMC10694565 DOI: 10.1016/j.invent.2023.100689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/13/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Purpose We describe the design and development of the European Platform to Promote health and wellbeing in the workplace (EMPOWER) digital intervention that provides an integrative user programme meeting the needs of employees and employers in addressing work stress. Results A user-centred design process was followed from January 2020 until November 2021. A tailored algorithm was developed to provide support at the individual employee level and the company level. Each element of the digital intervention was developed in English and then translated in Spanish, English, Polish and Finnish. The digital intervention consists of a website and a mobile application (app) that provides algorithm-based personalised content after assessing a user's somatic and psychological symptoms, work functioning, and psychosocial risk factors for work stress. It has a public section and an employer portal that provides recommendations to reduce psychosocial risks in their company based upon clustered input from employees. Usability testing was conducted and showed high ease of use and completion of tasks by participants. Conclusion The EMPOWER digital intervention is a tailored multimodal intervention addressing wellbeing, work stress, mental and physical health problems, and work productivity. This will be used in a planned RCT in four countries to evaluate its effectiveness.
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Affiliation(s)
| | - Jessie Shepherd
- MHARG, Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom
| | - Jessie Gevaert
- Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karen Van Aerden
- Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | | | | | - Ellen Vorstenbosch
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Paula Cristóbal-Narváez
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Mireia Felez-Nobrega
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Carlota de Miquel
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | | | | | - Marjo Sinokki
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Päivi Naumanen
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Frédérique van Krugten
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Marleen de Mul
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
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van der Feltz-Cornelis CM, Elfeddali I, Werneke U, Malt UF, Van den Bergh O, Schaefert R, Kop WJ, Lobo A, Sharpe M, Söllner W, Löwe B. A European Research Agenda for Somatic Symptom Disorders, Bodily Distress Disorders, and Functional Disorders: Results of an Estimate-Talk-Estimate Delphi Expert Study. Front Psychiatry 2018; 9:151. [PMID: 29867596 PMCID: PMC5961475 DOI: 10.3389/fpsyt.2018.00151] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/04/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe.
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Affiliation(s)
- Christina M. van der Feltz-Cornelis
- Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, Netherlands
- Tranzo Department, Tilburg University, Tilburg, Netherlands
| | - Iman Elfeddali
- Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, Netherlands
- Tranzo Department, Tilburg University, Tilburg, Netherlands
| | - Ursula Werneke
- Sunderby Research Unit, Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Ulrik F. Malt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section for Psychosomatic Medicine, Division of Mental Health and Dependency, University Hospital Oslo, Oslo, Norway
| | | | - Rainer Schaefert
- Division of Internal Medicine, Department of Psychosomatic Medicine, University and University Hospital Basel, Basel, Switzerland
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Willem J. Kop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Antonio Lobo
- Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERSAM, National Institute of Health Carlos III, Zaragoza, Spain
| | | | - Wolfgang Söllner
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Bernd Löwe
- Institute for Psychosomatic Medicine and Psychotherapy, University Clinic Hamburg-Eppendorf, Hamburg, Germany
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Lokman S, Volker D, Zijlstra-Vlasveld MC, Brouwers EP, Boon B, Beekman AT, Smit F, Van der Feltz-Cornelis CM. Return-to-work intervention versus usual care for sick-listed employees: health-economic investment appraisal alongside a cluster randomised trial. BMJ Open 2017; 7:e016348. [PMID: 28982815 PMCID: PMC5640022 DOI: 10.1136/bmjopen-2017-016348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 09/14/2017] [Accepted: 09/15/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the health-economic costs and benefits of a guided eHealth intervention (E-health module embedded in Collaborative Occupational healthcare (ECO)) encouraging sick-listed employees to a faster return to work. DESIGN A two-armed cluster randomised trial with occupational physicians (OPs) (n=62), clustered and randomised by region into an experimental and a control group, to conduct a health-economic investment appraisal. Online self-reported data were collected from employees at baseline, after 3, 6, 9 and 12 months. SETTING Occupational health care in the Netherlands. PARTICIPANTS Employees from small-sized and medium-sized companies (≥18 years), sick-listed between 4 and 26 weeks with (symptoms of) common mental disorders visiting their OP. INTERVENTIONS In the intervention group, employees (N=131) received an eHealth module aimed at changing cognitions regarding return to work, while OPs were supported by a decision aid for treatment and referral options. Employees in the control condition (N=89) received usual sickness guidance. OUTCOMES MEASURES Net benefits and return on investment based on absenteeism, presenteeism, health care use and quality-adjusted life years (QALYs) gained. RESULTS From the employer's perspective, the incremental net benefits were €3187 per employee over a single year, representing a return of investment of €11 per invested Euro, with a break-even point at 6 months. The economic case was also favourable from the employee's perspective, partly because of QALY health gains. The intervention was costing €234 per employee from a health service financier's perspective. The incremental net benefits from a social perspective were €4210. This amount dropped to €3559 in the sensitivity analysis trimming the 5% highest costs. CONCLUSIONS The data suggest that the ECO intervention offers good value for money for virtually all stakeholders involved, because initial investments were more than recouped within a single year. The sometimes wide 95% CIs suggest that the costs and benefits are not always very precise estimates and real benefits could vary considerably. TRIAL REGISTRATION NTR2108; Results.
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Affiliation(s)
- Suzanne Lokman
- Public Mental Health, Trimbos Institute, Utrecht, Netherlands
| | | | | | - Evelien Pm Brouwers
- Tranzo, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, Noord-Brabant, Netherlands
| | - Brigitte Boon
- Center of Innovation, Trimbos Institute, Utrecht, Netherlands
| | - Aartjan Tf Beekman
- EMGO Institute for Health and Care Research, Amsterdam, Netherlands
- Department of Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - Filip Smit
- Public Mental Health, Trimbos Institute, Utrecht, Netherlands
- EMGO Institute for Health and Care Research, Amsterdam, Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, Netherlands
| | - Christina M Van der Feltz-Cornelis
- Tranzo, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, Noord-Brabant, Netherlands
- Clinical Centre of Excellence for Body, Mind and Health, GGZ Breburg, Tilburg, Netherlands
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Volker D, Zijlstra-Vlasveld MC, Brouwers EPM, van der Feltz-Cornelis CM. Process Evaluation of a Blended Web-Based Intervention on Return to Work for Sick-Listed Employees with Common Mental Health Problems in the Occupational Health Setting. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:186-194. [PMID: 27150734 PMCID: PMC5405094 DOI: 10.1007/s10926-016-9643-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Purpose A blended web-based intervention, "eHealth module embedded in collaborative occupational health care" (ECO), aimed at return to work, was developed and found effective in sick-listed employees with common mental disorders. In order to establish the feasibility of ECO, a process evaluation was conducted. Methods Seven process components were investigated: recruitment, reach, dose delivered, dose received, fidelity, satisfaction and context. Quantitative and qualitative methods were used to collect data: an online questionnaire for the employees, website data, telephonic interviews with occupational physicians (OPs) and observations of the researchers. Results Recruitment was uncomplicated for the employees, but required several steps for the OPs. Reach was 100 % at the OP level and 76.3 % at the employee level. Dose delivered and received for OPs: 91.6 % received minimally one email message. Dose delivered and received for the employees: finishing of the different modules of ECO varied between 13 and 90 %. Fidelity: the support of the OP to the employee in ECO was lower than anticipated. Satisfaction: both employees and OPs were satisfied with the intervention. However, employees reported a need for more support in ECO. The context showed that OPs had limited time to support the employees and it was impossible for the employee to contact the OP outside their regular contacts. Conclusion Feasibility of ECO and satisfaction of employees and OPs with ECO were good. Fidelity of OPs was limited. For further implementation in the occupational health setting, especially contextual barriers regarding time limitation and accessibility of OPs for employees should be addressed.
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Affiliation(s)
- D Volker
- Trimbos-institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands.
- Tranzo Department, Tilburg University, Tilburg, The Netherlands.
| | - M C Zijlstra-Vlasveld
- Trimbos-institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands
| | - E P M Brouwers
- Tranzo Department, Tilburg University, Tilburg, The Netherlands
| | - C M van der Feltz-Cornelis
- Tranzo Department, Tilburg University, Tilburg, The Netherlands
- TopClinical Centre for Body, Mind and Health, GGZ Breburg, Tilburg, The Netherlands
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Tamminga SJ, Hoving JL, Frings-Dresen MHW, de Boer AGEM. Cancer@Work - a nurse-led, stepped-care, e-health intervention to enhance the return to work of patients with cancer: study protocol for a randomized controlled trial. Trials 2016; 17:453. [PMID: 27634549 PMCID: PMC5025547 DOI: 10.1186/s13063-016-1578-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 08/31/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although the importance of work for patients with cancer is nowadays more acknowledged both in the literature as well as in cancer survivorship care, effective interventions targeting the return to work of these patients are still scarce. Therefore, we developed a nurse-led, stepped-care, e-health intervention aimed at enhancing the return to work of patients with cancer. The objective of this study is to describe the content of the intervention and the study design used to evaluate the feasibility and (cost) effectiveness of the intervention. METHODS We designed a multi-centre randomised controlled trial with a follow-up of 12 months. Patients who have paid employment at the time of diagnosis, are on sick leave and are between 18-62 years old will be eligible to participate. After patients have signed the informed consent form and filled in the baseline questionnaire, they are randomly allocated to either the nurse-led, stepped-care, e-health intervention called Cancer@Work, or care as usual. The primary outcome is sustainable return to work. Secondary outcomes are sick leave days, work ability, work functioning, quality of life, quality of working life and time from initial sick leave to full return to work without extensive need for recovery. The feasibility of the Cancer@Work intervention and direct and indirect costs will be determined. Outcomes will be assessed by questionnaires at 3, 6, 9 and 12 months of follow-up. DISCUSSION The results of this study will provide new insights into the feasibility and (cost) effectiveness of Cancer@Work, a nurse-led, stepped-care, e-health intervention for cancer patients aimed at enhancing their return to work. If proven effective, the intention is to implement the Cancer@Work intervention in usual psycho-oncological care. TRIAL REGISTRATION NTR (Netherlands Trial Registry): NTR5190 . Registered on 18 June 2015.
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Jan L Hoving
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Volker D, Zijlstra-Vlasveld MC, Brouwers EPM, Homans WA, Emons WHM, van der Feltz-Cornelis CM. Validation of the Patient Health Questionnaire-9 for Major Depressive Disorder in the Occupational Health Setting. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:237-44. [PMID: 26377480 PMCID: PMC4854933 DOI: 10.1007/s10926-015-9607-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose Because of the increased risk of long-term sickness leave for employees with a major depressive disorder (MDD), it is important for occupational health professionals to recognize depression in a timely manner. The Patient Health Questionnaire-9 (PHQ-9) has proven to be a reliable and valid instrument for screening MDD, but has not been validated in the occupational health setting. The aim of this study was to validate the PHQ-9 for MDD within a population of employees on sickness leave by using the MINI-International Neuropsychiatric Interview (MINI) as a gold standard. Methods Participants were recruited in collaboration with the occupational health service. The study sample consisted of 170 employees on sickness leave between 4 and 26 weeks who completed the PHQ-9 and were evaluated with the MINI by telephone. Sensitivity, specificity, positive and negative predictive value, efficiency and 95 % confidence intervals (95 % CIs) were calculated for all possible cut-off values. A receiver operator characteristics (ROC) analysis was computed for PHQ-9 score versus the MINI. Results The optimal cut-off value of the PHQ-9 was 10. This resulted in a sensitivity of 86.1 % [95 % CI (69.7-94.8)] and a specificity of 78.4 % [95 % CI (70.2-84.8)]. Based on the ROC analysis, the area under the curve for the PHQ-9 was 0.90 [SE = 0.02; 95 % CI (0.85-0.94)]. Conclusion The PHQ-9 shows good sensitivity and specificity as a screener for MDD within a population of employees on sickness leave.
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Affiliation(s)
- D Volker
- Trimbos-Institute, Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.
- Tranzo, Tilburg University, Tilburg, The Netherlands.
| | - M C Zijlstra-Vlasveld
- Trimbos-Institute, Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | | | | | - W H M Emons
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - C M van der Feltz-Cornelis
- Tranzo, Tilburg University, Tilburg, The Netherlands
- Top Clinical Centre for Body, Mind and Health, GGZ Breburg, Tilburg, The Netherlands
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7
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Volker D, Zijlstra-Vlasveld MC, Anema JR, Beekman AT, Brouwers EP, Emons WH, van Lomwel AGC, van der Feltz-Cornelis CM. 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:e116. [PMID: 25972279 PMCID: PMC4468600 DOI: 10.2196/jmir.4097] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 12/17/2022] Open
Abstract
Background Common mental disorders are strongly associated with long-term sickness absence, which has negative consequences for the individual employee’s quality of life and leads to substantial costs for society. It is important to focus on return to work (RTW) during treatment of sick-listed employees with common mental disorders. Factors such as self-efficacy and the intention to resume work despite having symptoms are important in the RTW process. We developed “E-health module embedded in Collaborative Occupational health care” (ECO) as a blended Web-based intervention with 2 parts: an eHealth module (Return@Work) for the employee aimed at changing cognitions of the employee regarding RTW and a decision aid via email supporting the occupational physician with advice regarding treatment and referral options based on monitoring the employee’s progress during treatment. Objective This study evaluated the effect of a blended eHealth intervention (ECO) versus care as usual on time to RTW of sick-listed employees with common mental disorders. Methods The study was a 2-armed cluster randomized controlled trial. Employees sick-listed between 4 and 26 weeks with common mental disorder symptoms were recruited by their occupational health service or employer. The employees were followed up to 12 months. The primary outcome measures were time to first RTW (partial or full) and time to full RTW. Secondary outcomes were response and remission of the common mental disorder symptoms (self-assessed). Results A total of 220 employees were included: 131 participants were randomized to the ECO intervention and 89 to care as usual (CAU). The duration until first RTW differed significantly between the groups. The median duration was 77.0 (IQR 29.0-152.3) days in the CAU group and 50.0 (IQR 20.8-99.0) days in the ECO group (hazard ratio [HR] 1.390, 95% CI 1.034-1.870, P=.03). No significant difference was found for duration until full RTW. Treatment response of common mental disorder symptoms did not differ significantly between the groups, but at 9 months after baseline significantly more participants in the ECO group achieved remission than in the CAU group (OR 2.228, 95% CI 1.115-4.453, P=.02). Conclusions The results of this study showed that in a group of sick-listed employees with common mental disorders, applying the blended eHealth ECO intervention led to faster first RTW and more remission of common mental disorder symptoms than CAU. Trial Registration Netherlands Trial Register NTR2108; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2108. (Archived by WebCite at http://www.webcitation.org/6YBSnNx3P).
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Affiliation(s)
- Daniëlle Volker
- Trimbos Institute, Netherlands institute of mental health and addiction, Utrecht, Netherlands.
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van Eck van der Sluijs J, ten Have M, Rijnders C, van Marwijk H, de Graaf R, van der Feltz-Cornelis C. Medically unexplained and explained physical symptoms in the general population: association with prevalent and incident mental disorders. PLoS One 2015; 10:e0123274. [PMID: 25853676 PMCID: PMC4390312 DOI: 10.1371/journal.pone.0123274] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 02/18/2015] [Indexed: 12/02/2022] Open
Abstract
Background Clinical studies have shown that Medically Unexplained Symptoms (MUS) are related to common mental disorders. It is unknown how often common mental disorders occur in subjects who have explained physical symptoms (PHY), MUS or both, in the general population, what the incidence rates are, and whether there is a difference between PHY and MUS in this respect. Aim To study the prevalence and incidence rates of mood, anxiety and substance use disorders in groups with PHY, MUS and combined MUS and PHY compared to a no-symptoms reference group in the general population. Method Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 18-64 years. We selected subjects with explained physical symptoms only (n=1952), with MUS only (n=177), with both MUS and PHY (n=209), and a reference group with no physical symptoms (n=4168). The assessment of common mental disorders was through the Composite International Diagnostic Interview 3.0. Multivariate logistic regression analyses were used to examine the association between group membership and the prevalence and first-incidence rates of comorbid mental disorders, adjusted for socio-demographic characteristics. Results MUS were associated with the highest prevalence rates of mood and anxiety disorders, and combined MUS and PHY with the highest prevalence rates of substance disorder. Combined MUS and PHY were associated with a higher incidence rate of mood disorder only (OR 2.9 (95%CI:1.27,6.74)). Conclusion In the general population, PHY, MUS and the combination of both are related to mood and anxiety disorder, but odds are highest for combined MUS and PHY in relation to substance use disorder. Combined MUS and PHY are related to a greater incidence of mood disorder. These findings warrant further research into possibilities to improve recognition and early intervention in subjects with combined MUS and PHY.
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Affiliation(s)
- Jonna van Eck van der Sluijs
- Topclinical Centre for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands
- Tranzo department, Tilburg University, Tilburg, the Netherlands
- * E-mail:
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Cees Rijnders
- Department of Residency training, GGz Breburg, Tilburg, The Netherlands
| | - Harm van Marwijk
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, United Kingdom
- Department of General Practice & Elderly Care Medicine and the EMGO+-Institute for Health and Care Research of VU University medical centre (VUmc), Amsterdam, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Christina van der Feltz-Cornelis
- Topclinical Centre for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands
- Tranzo department, Tilburg University, Tilburg, the Netherlands
- Department of Residency training, GGz Breburg, Tilburg, The Netherlands
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