A Cluster-Randomised Trial Evaluating an Intervention for Patients with Stress-Related Mental Disorders and Sick Leave in Primary Care Results of the MISS Project
2007

Evaluating an Intervention for Stress-Related Mental Disorders in Primary Care

Sample size: 433 publication Evidence: low

Author Information

Author(s): Bakker Ingrid M, Terluin Berend, van Marwijk Harm W. J, van der Windt Daniëlle A. W. M, Rijmen Frank, van Mechelen Willem, Stalman Wim A. B

Primary Institution: VU University Medical Center Amsterdam

Hypothesis

The MISS would be more effective than usual care in reducing sick leave for patients with stress-related mental disorders.

Conclusion

The study found no evidence that the MISS intervention was more effective than usual care in reducing sick leave duration.

Supporting Evidence

  • Patients in both groups showed a reduction in symptom severity over 12 months.
  • More practitioners in the intervention group recognized patients as having stress-related mental health problems.
  • Subgroup analysis suggested that patients diagnosed with stress-related mental disorders returned to work slightly faster in the intervention group.

Takeaway

Doctors tried a new way to help people with stress-related problems who were on sick leave, but it didn't work better than the usual help they get.

Methodology

A cluster-randomised controlled trial involving 46 primary care physicians and 433 patients with sick leave and elevated distress levels.

Potential Biases

Potential bias in diagnosis due to the training of physicians in the intervention group, leading to differences in patient severity.

Limitations

The intervention may not have been applied effectively by physicians due to time constraints, and the patient inclusion criteria may have been too broad.

Participant Demographics

66.3% of participants were women, aged 20-60 years.

Statistical Information

P-Value

0.239

Confidence Interval

95% CI 0.87–1.29

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pctr.0020026

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