Guideline-Based Care of Common Mental Disorders by Occupational Physicians (CO-OP study): A Randomized Controlled Trial

Objective: To evaluate the effectiveness of guideline-based care (GBC) of workers with mental health problems, which promotes counseling by the occupational physician (OP) facilitating return to wont (RTW). Methods: In a randomized controlled trial, with police workers on sick leave due to mental health problems (n = 240), trained OPs delivered GBC in the intervention group. Time to RTW and recurrences during 1-year follow-up, analyzed, using Cox proportional hazards models, were compared with usual care (UC) with easy access to a psychologist. Results: GBC by OPs did not result in earlier RTW than UC. Subgroup analysis showed a small effect in favor of GBC for workers with administrative functions and/or "minor" stress-related symptoms. Conclusions: GBC did not differ in RTW compared with UC, but may be beneficial for the majority of workers with minor stress-related disorders. (J Occup Environ Med. 2009,51:305-312)