Effectiveness of Psychotherapeutic Consultation at Work Compared to Care as Usual for Employees with Common Mental Disorders or Subthreshold Symptoms: A Randomized Controlled Multicenter Trial in Germany

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INTRODUCTION: Common mental disorders (CMDs) are often work-related, impact work ability and are undertreated. This trial investigates whether psychotherapeutic consultation at work (PT-A) is more effective than care as usual (CAU) in reducing days of sickness absence (DOSA) among affected employees. METHODS: A randomized controlled trial (RCT) in five German study centers included employees with CMD or global assessment of functioning (GAF) <81, working ≥15 h/week, recruited via companies and media. After baseline, participants were randomized 1:1 to intervention (IG: up to 16 individual psychotherapy sessions over 9 months) or control (CG: diagnostic session + follow-up call) group. The primary outcome was self-reported DOSA in the last 6 months at 15 months post-baseline (T2). Analyses used intention-to-treat. RESULTS: From 09/2021 to 01/2023, 550 participants, 246 male, 301 female, and 1 diverse, were randomized to IG (n = 279) and CG (n = 270). A total of 403 participants (74%) were first-time users of mental health care. DOSA at T2 were 21 days (SD = 39) in the IG (n = 206) versus 22 days (SD = 39) in the CG (n = 161), no significant treatment effect was observed ([0.65; 1.32], p = 0.679). CONCLUSION: PT-A did not significantly reduce DOSA compared to CAU. However, secondary outcomes showed considerable improvement of clinical symptoms such as depression, anxiety and return-to-work self-efficacy. Therefore, longer observation periods may be needed to assess the effects on DOSA. Moreover, compared to clinical experiences, the high number of men and first-time users indicate an improved accessibility for underserved groups of employees.

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