Background Depression has both implications for return-to-work and for work limitations in injured workers with musculoskeletal disorders who returned to work, but little is known about the course of depression and work limitations over time. The aims were 1) to identify trajectories of depression and work limitations over 2-year follow-up and 2) to determine factors associated with trajectory group membership from demographic, work and health characteristics.
Methods We used data from 632 workers with a musculoskeletal disorder. Data were collected at baseline and at 6,12 and 24 months follow-up. Depressive symptoms were measured with the CES-D. The Work Limitations Questionnaire was used to assess work limitations. We used Latent Growth Modelling to identify parallel trajectory groups of depression and work limitations and the impact of demographic, work and health characteristics on trajectory group membership.
Results A four-class trajectory was chosen as best fitting and substantively meaningful model. Group 1 (37.7%) represented with the lowest scores for depression and work limitations and both scores decreased over time; group 2 (12.8%) had both very high depression and work limitations scores that almost stayed constant over the 2-year follow-up period; group 3 (15.0%) consisted of workers with medium scores of both depression and work limitations and group 4 (34.0%) had high scores of work limitations, which decreased dramatically (from 80 to 20), and depression that also decreased significantly, but not as but not as much as work limitations. Return-to-work, self-efficacy, mental and physical health scores showed significant differences between some of the groups.
Conclusion Distinct trajectories of depression and work limitations in injured workers were identified. Return-to-work and health characteristics predicted trajectory group membership. Health care providers should be aware of the course of depression and work limitations over time in injured workers and may monitor both concepts closely after injury.
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