New Treatment for Anxiety and Depression Doubles the Rate of Return to Work
Norwegian study: A brief, treatment model with a work focus for anxiety and depression halves sick leave compared to patients waiting for treatment.
A Norwegian randomized controlled trial, published in The Lancet eClinicalMedicine, shows that a short treatment model combining metacognitive therapy and job-related components, doubles the number of people returning to work compared with those on a waiting list. At the same time, symptoms are significantly reduced.
Norway has a high level of sick leave, with mental disorders accounting for a large and increasing share. Mental disorders are the most frequent cause of long-term sick leave and disability in Norway.
“Many types of therapy reduce symptoms, but do not affect sick leave. Here, we see both – in a regular outpatient clinic,” says Ragne Gjengedal, psychologist specialist, researcher at Diakonhjemmet Hospital, and first author of the study. No previous randomized study among Norwegian patients with anxiety and depression has shown such a strong effect on both sick leave and symptoms.
The treatment model combined metacognitive therapy with job-oriented interventions and was found to be economically beneficial for society. The cost of the intervention was nearly tripled in savings through reduced sick leave.
Key findings
- 42% returned to work after 12 weeks of treatment – compared with 18% in the waiting-list group.
- 22 fewer days of sick leave per patient during the first year.
- Economic benefit to society: NOK 78,452 saved per patient.
- Treatment cost per patient: NOK 27,191 → approximately threefold savings.
- After completing treatment (all 236 patients): about 75% recovered or showed significant symptom improvement.
- Nearly 85% were in full-time work one year after starting treatment.
- Average treatment time: approximately 10 hours.
How the treatment works
The treatment model combines metacognitive therapy (MCT) with tailored job-focused strategies:
- MCT helps patients find better strategies for managing difficult thoughts and emotions by reducing overthinking and increasing flexible attention.
- Job-focused strategies involve identifying challenges at work and developing a concrete return-to-work plan: implement learned strategies also in the work context, ensuring good communication and adjustments, gradual work resumption – or changing jobs if necessary.
Implications for mental health services
The researchers believe the results show that metacognitive therapy and job-oriented components, can be implemented in standard outpatient care at community mental health centers.
“Early, targeted treatment with a clear work focus and high quality pays off – for patients, workplaces, and society,” says Gjengedal.
By integrating a work focus into treatment for anxiety and depression, patients return to work more quickly and gain increased work functioning, in addition to substantial symptom improvement.
Contact
- Ragne Gjengedal, Psychologist Specialist, Researcher at Diakonhjemmet Hospital, and first author of the study. Phone: +47 926 63 532 | Email: ragne.gjengedal@diakonsyk.no
- Pernille Lønne Mørkhagen, Head of Communications, Diakonhjemmet Hospital. Phone: +47 982 03 145 | Email: pernille.l.morkhagen@diakonsyk.no