Gunnel Åbjörnsson

Return to work after a workplace-oriented intervention for patients on sick-leave for burnout - a prospective controlled study

BackgroundIn the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.MethodsIn a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.ResultsThere was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.ConclusionsWe conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.Trial registrationCurrent Controlled Trials NCT01039168.

Long-term follow-up of psychological distress, social functioning, and coping style in treated and untreated patients with solvent-induced chronic toxic encephalopathy.

Patients with organic solvent-induced toxic encephalopathy (TE) (n = 13) were followed up seven years after the application of an intervention program. They were also compared with untreated TE patients diagnosed at the same time (n = 26) and with unexposed referents (n = 39). Psychological distress, social function, and coping ability and style were measured with the Symptom Checklist-90, Interview Schedule of Social Interaction, and Sense of Coherence and Strategies to Handle Stress questionnaires. Both TE groups had unchanged function in neuropsychological tests. Members of the treated group had improved their social functioning and reduced their mental stress but were not any better than the untreated patients. Compared with referents, the TE patients continued to live with increased psychological distress and used predominantly emotionally focused strategies to cope with their problems. This can be a cause for concern in family life and can also make gainful work impossible.

Stress management in men with solvent-induced chronic toxic encephalopathy.

Stress management was studied in male patients with solvent-induced chronic toxic encephalopathy (TE) of types 2A (TE 2A, n = 31) and 2B (TE 2B, n = 26). The patients were compared with a healthy reference group (n = 57). Self-reported symptoms (90-item Symptoms Checklist [SCL-90]), sense of coherence, coping strategies, and level of mastery were measured. As expected, both TE groups reported highly deviating symptoms on most SCL-90 scales. The TE 2B patients, who had objectified cognitive dysfunction, reported more use of passive, less situationally adequate coping strategies; a weaker sense of coherence; and a lower degree of mastery. In contrast, the TE 2A cases showed only minor deviations from the reference group in these respects. The results suggest that having a strong sense of coherence, a sense of mastery, and flexible resources for stress management could be dependent on intact brain functions.

Psychological distress and coping in women married to men with a diagnosis of solvent-induced chronic toxic encephalopathy.

Background: Solvent-induced chronic toxic encephalopathy (TE) is a slowly developing brain disorder associated with both a direct effect on the nervous system and as indirect experienced psychological distress. It can presumably also imply negative influence on the subjects social surroundings. Methods: Seventeen women married to men diagnosed with TE (WTE) and 51 referent women of the same age married to healthy husbands were examined. Symptoms, social network and coping style were measured by questionnaires. Results: The WTE reported slightly more psychological distress and fewer social contacts than did the referents. The WTE did not report affected stress management. Retired women in the WTE group accounted for most of the deviances from the referents. Conclusions: The conclusion is that becoming a WTE does not necessarily imply more psychological distress, social isolation or poorer stress management capability if they continue with their work and social activities.