Reducing long term sickness absence by an activating intervention in adjustment disorders: A cluster randomized controlled design.

Authors: van Erp, N., Giesen, F., van Weeghel, J., Kroon, H., Michon, H., Becker, D., McHugo, G., & Drake, R.
Year Published 2003
Publication Occupational and Environmental Medicine
Volume 60
Number 6
Pages 429-437
Publisher Williams and Wilkins

Sickness leave is generally considered as a major source of societal costs in Western countries. With the increase in mental workload of the past decades, the fraction of psychological problems related to occupational stress has increased rapidly. These problems are also reported in the literature as emotional distress or stress related disorders.


To compare an innovative activating intervention with care as usual (control group) for the guidance of employees on sickness leave because of an adjustment disorder. It was hypothesized that the intervention would be more effective than care as usual in lowering the intensity of symptoms, increasing psychological resources, and decreasing sickness leave duration.


The study was conducted at Royal KPN, a private company providing postal and telecom services.


The study sample included 192 people who were on sick leave.

Data Collection

Symptom intensity, sickness duration, and return to work rates were measured at 3 months and 12 months. Analyses were performed on an intention to treat basis.


The control condition was care as usual.


At 3 months, significantly more patients in the intervention group had returned to work compared with the control group. At 12 months all patients had returned to work, but sickness leave was shorter in the intervention group than in the control group. The recurrence rate was lower in the intervention group. There were no differences between the two study groups with regard to the decrease of symptoms. At baseline, symptom intensity was higher in the patients than in a normal reference population, but decreased over time in a similar manner in both groups to approximately normal levels.


The experimental intervention for adjustment disorders was successful in shortening sick leave duration, mainly by decreasing long term absenteeism.

Disabilities Emotional disturbance
Populations Male & Female
Outcomes Return to work
Research Design Randomized Controlled Trials (RCTs)
Peer Reviewed Yes