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Guideline-Based Care of Common Mental Disorders by Occupational Physicians (CO-OP study): A Randomized Controlled Trial

Rebergen, D S. MSc; Bruinvels, D J. MD, PhD; Bezemer, P D. PhD; van der Beek, A J. PhD; van Mechelen, W MD, PhD

Journal of Occupational and Environmental Medicine: March 2009 - Volume 51 - Issue 3 - p 305-312
doi: 10.1097/JOM.0b013e3181990d32
Original Articles

Objective: To evaluate the effectiveness of guideline-based care (GBC) of workers with mental health problems, which promotes counseling by the occupational physician (OP) facilitating return to work (RTW).

Methods: In a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240), trained OPs delivered GBC in the intervention group. Time to RTW and recurrences during 1-year follow-up, analyzed using Cox proportional hazards models, were compared with usual care (UC) with easy access to a psychologist.

Results: GBC by OPs did not result in earlier RTW than UC. Subgroup analysis showed a small effect in favor of GBC for workers with administrative functions and/or “minor” stress-related symptoms.

Conclusions: GBC did not differ in RTW compared with UC, but may be beneficial for the majority of workers with minor stress-related disorders.

From the Departments of Public and Occupational Health (Dr. Rebergen, Dr. Bruinvels, Prof. van der Beek, Prof. van Mechelen) and Clinical Epidemiology and Biostatistics (Dr. Bezemer), EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.

CME Available for this Article at

The authors of both this article and its companion article, “Cost-Effectiveness of Guideline-Based Care for Workers with Mental Health Problems,” have no financial interest related to this research.

Address correspondence to: David J. Bruinvels, MD, PhD, EMGO Institute, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; E-mail:

©2009The American College of Occupational and Environmental Medicine