Return to work perceptions and actual return to work in workers with common mental disorders.

Introduction: Return to work (RTW) perceptions have been found to predict actual RTW of workers with common mental disorders. This study aims to (1) assess the relative value of RTW self-efficacy (RTW-SE) and RTW expectation in predicting actual RTW and (2) explore the role of mental health symptoms, work characteristics and their interaction as determinants of these RTW perceptions at baseline and over time.

Methods: Workers (N = 179) with common mental disorders were included at the start of their sick leave and followed-up at 3, 6, 9, and 12 months. RTW self-efficacy, RTW expectation, mental health and RTW were assessed by self-report. Kaplan-Meier survival analysis was used to test the predictive value of RTW-SE and RTW expectation against the actual RTW. Linear regression was used to study the associations of mental health symptoms, work characteristics and their interaction with RTW-SE at baseline. Mental health symptoms in relation to RTW-SE over the first 6 months were analyzed using Linear Mixed Models.

Results: Compared to RTW expectation, differences in RTW-SE were more predictive of actual RTW. At baseline, lower fatigue, depressive symptoms, and work pace- and load were associated with higher RTW-SE. Decreasing levels of fatigue and depressive symptoms over time were associated with parallel improvements in RTW-SE. Workers with high work pace and workload at baseline showed lower levels of RTW-SE at all time points.

Conclusions: We recommend the use of the RTW-SE scale to detect workers with common mental disorders at risk of a late RTW. Work characteristics and changes in mental health symptoms were associated with RTW-SE over time.