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Standardized multimodal intervention for stress-induced exhaustion disorder: an open trial in a clinical setting
BMC Psychiatry ( IF 3.4 ) Pub Date : 2020-11-05 , DOI: 10.1186/s12888-020-02907-3
Jakob Clason van de Leur 1 , Monica Buhrman 1 , Fredrik Åhs 2 , Alexander Rozental 3 , Gunilla Brodda Jansen 4
Affiliation  

Long-term sick-leave due to stress-related ill-health is increasing in several economically developed countries. Even though different forms of interventions are administered in regular care for stress-related disorders, such as Stress-induced Exhaustion disorder (SED), the scientific evidence for the effectiveness of such treatments is sparse. The objective of this study was to explore changes in SED-symptoms and return-to-work-rates in a large group of SED-patients participating in a standardized Multimodal intervention (MMI) in a clinical setting. This open clinical trial tracked 390 patients who fulfilled the criteria for SED undergoing a 24-week MMI, including return-to-work-strategies. Before inclusion, all patients underwent a multi-professional assessment by a team of licensed physicians, licensed psychologists, and licensed physiotherapists. Self-rated questionnaires were administered before treatment, at treatment-start, mid-treatment, post-treatment, and at 12-month follow-up. Within-group change was evaluated over time with mixed-effects models. Beyond different symptoms, working time, sick-leave compensation, and adverse effects were also measured. There were significant improvements in symptoms of SED, burnout, anxiety, depression, and insomnia, with large within-group effect sizes (d = 0.91–1.76), improvements that were maintained at 12-month follow-up. Furthermore, there was a significant increase in quality of life and large improvements in average working time and sick-leave compensation. Some adverse effects were reported, mainly concerning an increase in stress, anxiety, and worry. SED-patients participating in this standardized MMI reported large symptom alleviation, increased working time and reduced sick-leave compensation, indicating a beneficial treatment. There were some adverse effects, but no more so than other psychological treatments. This study confirms previous findings that high levels of depression and anxiety decrease to sub-clinical levels during treatment, while symptoms of SED also decline, yet still persists above sub-clinical levels at 12-month follow-up. On the whole, this open clinical trial suggests that a standardized MMI, administered in a clinical setting, improves symptoms and return-to-work rates in a clinically representative SED-population. This study was registered on Clinicaltrials.gov 2017.12.02 (Identifier: NCT03360136 ).

中文翻译:

压力性衰竭障碍的标准化多模式干预:临床环境中的公开试验

在一些经济发达国家,由于与压力相关的健康问题导致的长期病假正在增加。尽管在压力相关疾病的常规护理中采用了不同形式的干预措施,例如压力诱发的力竭障碍 (SED),但有关此类治疗有效性的科学证据却很少。本研究的目的是探讨在临床环境中参与标准化多模式干预 (MMI) 的一大群 SED 患者的 SED 症状和重返工作岗位率的变化。这项开放的临床试验跟踪了 390 名符合 SED 标准的患者,他们接受了 24 周的 MMI,包括重返工作岗位的策略。在纳入之前,所有患者都接受了由执业医师、执业心理学家、和有执照的物理治疗师。自评问卷在治疗前、治疗开始时、治疗中、治疗后和 12 个月随访时进行。随着时间的推移,使用混合效应模型评估组内变化。除了不同的症状外,还测量了工作时间、病假补偿和不利影响。SED、倦怠、焦虑、抑郁和失眠的症状有显着改善,组内效应量大(d = 0.91-1.76),在 12 个月的随访中保持改善。此外,生活质量显着提高,平均工作时间和病假补偿大幅改善。报告了一些不良反应,主要涉及压力、焦虑和担忧的增加。参与此标准化 MMI 的 SED 患者报告症状明显缓解、工作时间增加和病假补偿减少,表明治疗是有益的。有一些副作用,但不比其他心理治疗更严重。该研究证实了先前的研究结果,即治疗期间高水平的抑郁和焦虑降低至亚临床水平,而 SED 的症状也有所下降,但在 12 个月的随访中仍持续高于亚临床水平。总体而言,这项开放的临床试验表明,在临床环境中实施的标准化 MMI 可以改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。增加的工作时间和减少的病假补偿,表明一种有益的治疗。有一些副作用,但不比其他心理治疗更严重。该研究证实了先前的研究结果,即治疗期间高水平的抑郁和焦虑降低至亚临床水平,而 SED 的症状也有所下降,但在 12 个月的随访中仍持续高于亚临床水平。总体而言,这项开放的临床试验表明,在临床环境中实施的标准化 MMI 可以改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。增加的工作时间和减少的病假补偿,表明一种有益的治疗。有一些副作用,但不比其他心理治疗更严重。该研究证实了先前的研究结果,即治疗期间高水平的抑郁和焦虑降低至亚临床水平,而 SED 的症状也有所下降,但在 12 个月的随访中仍持续高于亚临床水平。总体而言,这项开放的临床试验表明,在临床环境中实施的标准化 MMI 可以改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。该研究证实了先前的研究结果,即治疗期间高水平的抑郁和焦虑降低至亚临床水平,而 SED 的症状也有所下降,但在 12 个月的随访中仍持续高于亚临床水平。总体而言,这项开放的临床试验表明,在临床环境中实施的标准化 MMI 可以改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。该研究证实了先前的研究结果,即治疗期间高水平的抑郁和焦虑降低至亚临床水平,而 SED 的症状也有所下降,但在 12 个月的随访中仍持续高于亚临床水平。总体而言,这项开放的临床试验表明,在临床环境中实施的标准化 MMI 可以改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。改善具有临床代表性的 SED 人群的症状和重返工作岗位的比率。该研究已在 Clinicaltrials.gov 2017.12.02 上注册(标识符:NCT03360136)。
更新日期:2020-11-06
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