Interpretation of results
anxiety
DISORDERS
Our intervention led to patients returning earlier to their workplaces and going to work more frequently compared to control group patients at 6 months follow-up. The patients in the control group returned later to their workplace. Thus, they needed 12 months to reach the share of returned patients that the intervention group reached at 6 months. The numerical difference in days at work persisted within 12 months, however, this difference (main outcome) proved not to be statistically significant.We believe that a number of factors might be responsible for this (negative) finding for the main outcome after 12 months. First, this might be due to a “ceiling effect” as 86% of the patients in the intervention group were already back at work after 6 months. Possibly, we had underestimated the wake of a labor market in the Munich area, which has been increasingly characterized with skills shortage—even during the Corona pandemic (which did not lead to relevant increase in unemployment rates). Second, statistical effects (large confidence intervals, lower number of observed cases at 12 months compared to 6 months) might be responsible for the negative finding.Third, there is evidence that the recovery rate increases, when health insurance benefits end [Regarding potential mediators of the effects observed, we could not find the expected relationships, for example, a higher uptake of structured RTW measures or a better feeling of preparedness in the intervention group. Thus, on the one hand, it might not be the mere uptake of existing measures but rather their (case)managed implementation within a context that sees RTW as a desirable process. On the other hand, intervention patients might have suffered from an increase of anxiety when confronted with RTW [Despite the non-superiority of our intervention regarding the main outcome, our study still yielded stronger/comparable effects compared to other studies focusing on common mental disorders. Thus, for adjustment disorders, CBT alone was found not to reduce time to RTW [