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An international comparison of occupational health guidelines for the management of mental disorders and stress-related psychological symptoms
  1. Margot C W Joosen1,
  2. Evelien P M Brouwers1,
  3. Karlijn M van Beurden1,
  4. Berend Terluin2,
  5. Jani H Ruotsalainen3,
  6. Jong-Min Woo4,
  7. Kyeong-Sook Choi5,
  8. Hisashi Eguchi6,
  9. Jiro Moriguchi7,
  10. Jac J L van der Klink1,8,
  11. Jaap van Weeghel1,9,10
  1. 1Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg, The Netherlands
  2. 2Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
  3. 3Cochrane Occupational Safety and Health Review Group, Finnish Institute of Occupational Health, Kuopio, Finland
  4. 4Department of Psychiatry and Stress Research Institute, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Republic of Korea
  5. 5Department of Neuropsychiatry, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea
  6. 6Department of Public Health, Kitasto University School of Medicine, Sagamihara, Kanagawa, Japan
  7. 7Department of Occupational Health Promotion, Kyoto Industrial Health Association, Kyoto, Japan
  8. 8Department of Health Sciences, Division of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  9. 9Phrenos Centre of Expertise, Utrecht, The Netherlands
  10. 10Parnassia Group, Dijk en Duin Mental Health Center, Castricum, The Netherlands
  1. Correspondence to Dr Margot C W Joosen, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, P.O. Box 90153, Tilburg 5000 LE, The Netherlands; m.c.w.joosen{at}


Background We compared available guidelines on the management of mental disorders and stress-related psychological symptoms in an occupational healthcare setting and determined their development and reporting quality.

Methods To identify eligible guidelines, we systematically searched National Guideline Clearinghouse, Guidelines International Network Library and PubMed. Members of the International Commission on Occupational Health (ICOH), were also consulted. Guidelines recommendations were compared and reporting quality was assessed using the AGREE II instrument.

Results Of 2126 titles retrieved, 14 guidelines were included: 1 Japanese, 2 Finnish, 2 Korean, 2 British and 7 Dutch. Four guidelines were of high-reporting quality. Best described was the Scope and Purpose, and the poorest described were competing interests (Editorial independence) and barriers and facilitators for implementation (Applicability). Key recommendations were often difficult to identify. Most guidelines recommend employing an inventory of symptoms, diagnostic classification, performance problems and workplace factors. All guidelines recommend specific return-to-work interventions, and most agreed on psychological treatment and communication between involved stakeholders.

Discussion Practice guidelines to address work disability due to mental disorders and stress-related symptoms are available in various countries around the world, however, these guidelines are difficult to find. To promote sharing, national guidelines should be accessible via established international databases. The quality of the guideline's developmental process varied considerably. To increase quality and applicability, guideline developers should adopt a common structure for the development and reporting of their guidelines, for example Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. Owing to differences in social systems, developers can learn from each other through reviews of this kind.

  • Mental Health < General expertise
  • Practice guidelines
  • Return-to-work
  • Systematic review

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