Article Text

Download PDFPDF
Systematic review and meta-analysis of interventions aimed at enhancing return to work for sick-listed workers with common mental disorders, stress-related disorders, somatoform disorders and personality disorders
  1. Mai Bjørnskov Mikkelsen1,
  2. Michael Rosholm2,3
  1. 1 Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
  2. 2 Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
  3. 3 IZA, Bonn, Germany
  1. Correspondence to Professor Michael Rosholm, Department of Economics and Business, Aarhus University, Aarhus DK8210, Denmark; rom{at}


Objectives Mental disorders are associated with significant functional impairment, sickness absence and disability. The consequences of sickness absence warrant investigation into interventions aimed at enhancing return to work (RTW) for workers with mental disorders. The present systematic review and meta-analysis aim to synthesise evidence on the effectiveness of interventions aimed at enhancing RTW in sick-listed workers with mental disorders.

Methods EconLit, Embase, PsychInfo, PubMed, Svemed+ and Web of Science were searched for peer-reviewed, randomised or controlled studies assessing employment-related outcomes of interventions. A meta-analysis was conducted and meta-regressions were performed to explore prespecified potential sources of heterogeneity between studies.

Results The literature search yielded 3777 publications of which 42 (n=38 938) were included in the systematic review and 32 (n=9459) had appropriate data for the meta-analysis. The pooled effect size (95 % CI) was 0.14 (0.07 to 0.22). Meta-regressions revealed that the heterogeneity could not be attributed to study quality, timing of the intervention or length of the intervention. However, it could be partly explained by number of components included in the intervention, if the intervention included contact to the work place and by the disorder targeted by the intervention.

Conclusions The results reveal strong evidence for interventions including contact to the work place and multicomponent interventions and moderate evidence for interventions including graded RTW. In addition, the results provide strong evidence for interventions targeting stress compared with interventions targeting other mental disorders. The findings point to important implications for policy and design of future interventions.

  • sickness absence
  • mental health
  • intervention studies

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors Review conception and design: MBM and MR. Acquisition of data: MBM and MR. Systematic review and data-interpretation: MBM and MR. Meta-analysis: MR. Drafting of manuscript: MBM. Critical revision: MBM and MR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data available in reviewed articles.

  • Preregistration Prospero: CRD42017070410.