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Randomized Controlled Trial
. 2017 Oct;74(10):717-725.
doi: 10.1136/oemed-2016-104248. Epub 2017 May 25.

Effect on return to work or education of Individual Placement and Support modified for people with mood and anxiety disorders: results of a randomised clinical trial

Lone Hellström  1 , Per Bech  2 , Carsten Hjorthøj  1 , Merete Nordentoft  1 , Jane Lindschou  3 , Lene Falgaard Eplov  1
Affiliations
Randomized Controlled Trial

Effect on return to work or education of Individual Placement and Support modified for people with mood and anxiety disorders: results of a randomised clinical trial

Lone Hellström et al. Occup Environ Med. 2017 Oct.

Abstract

Objectives: The effect of Individual Placement and Support (IPS) on return to work or education among people with mood or anxiety disorders is unclear, while IPS increases return to work for people with severe mental illness. We examined the effect of IPS modified for people with mood and anxiety disorders (IPS-MA) on return to work and education compared with services as usual (SAU).

Methods: In a randomised clinical superiority trial, 326 participants with mood and anxiety disorders were centrally randomised to IPS-MA, consisting of individual mentor support and career counselling (n=162) or SAU (n=164). The primary outcome was competitive employment or education at 24 months, while weeks of competitive employment or education, illness symptoms and level of functioning, and well-being were secondary outcomes.

Results: After 24 months, 44.4% (72/162) of the participants receiving IPS-MA had returned to work or education compared with 37.8% (62/164) following SAU (OR=1.34, 95% CI: 0.86 to 2.10, p=0.20). We found no difference in mean number of weeks in employment or education (IPS-MA 32.4 weeks vs SAU 26.7 weeks, p=0.14), level of depression (Hamilton Depression 6-Item Scale score IPS-MA 5.7 points vs SAU 5.0 points, p=0.12), level of anxiety (Hamilton Anxiety 6-Item Scale score IPS-MA 5.8 points vs SAU 5.1 points, p=0.17), level of functioning (Global Assessment of Functioning IPS-MA 59.1 points vs SAU 59.5 points, p=0.81) or well-being measured by WHO-Five Well-being Index (IPS-MA 49.6 points vs SAU 48.5 points, p=0.83) at 24 months.

Conclusion: The modified version of IPS, IPS-MA, was not superior to SAU in supporting people with mood or anxiety disorders in return to work at 24 months.

Trial registration number: NCT01721824.

Keywords: Supported employment; affective disorder; anxiety.

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Conflict of interest statement

Competing interests: Managerial responsibility and supervision lie with LFE, MN and PB. Sherpa has had no role in the trial design, collection, analysis or interpretation of data nor in publication of data from the trial. Due to administrative convenience, LH was formally employed by Sherpa from 1 June 2011 until 31 August 2013. LH’s PhD has exclusively been funded by external funding, and LH has throughout the entire period been working at the Research Unit at Mental Health Centre Copenhagen, where she is now employed. None of the other authors has any competing interest.

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