A Register-Based Study of Occupational Functioning in Non-Psychotic Patients Before and After Psychotherapy

ABSTRACT

Mental disorders are an important cause of occupational impairments. Little is known about whether psychotherapeutic treatment helps patients function in their jobs. This study investigated long-term changes in occupational functioning for patients referred to treatment.

We recruited 747 consecutive patients and 14,940 matched control subjects. Data on days on sick leave, unemployment and disability pension were collected for 2002-2007 from central registries and analyzed.

Of the 747 patients, 216 did not show up for treatment and 531 completed treatment. Patients who completed treatment (completer patients) had, on average, 15.7 days on sick leave two years before treatment and 23.1 days on sick leave two years after treatment, while the control group had 5.4 and 7.5 days, respectively. Regarding disability pension, completer patients had 7.6 days before and 14.9 days after treatment, while the control group had 7.8 and 11.0 days, respectively. Regarding unemployment completer patients had 13.9 and 10.1 days, while control group had 9.0 and 8.3 days, respectively. The analysis of covariance (ANCOVA) showed that completer patients had a significantly higher number of days on sick leave (p<0.001) and disability pension (p=0.010) compared to the control group, while the change in days with unemployment was insignificant (p=0.501).

Occupational outcome of psychotherapy may be less advantageous than shown in previous studies. Differences can perhaps be explained by the length and symmetry of the observation period before and after intervention. Other possible reasons for the outcome are: disorder chronicity; a labor market that excludes individuals with mental disorders; and that psychotherapy does not address occupational functioning.

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