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Predictors of returning to work

P Ash1, S I Goldstein

  • 1Emory University School of Medicine, Atlanta, GA, USA.

The Bulletin of the American Academy of Psychiatry and the Law
|January 1, 1995
PubMed
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Depression significantly hinders physically injured workers from returning to work, even with vocational rehabilitation. Addressing depression is crucial for successful employment outcomes in workers' compensation cases.

Area of Science:

  • Occupational medicine
  • Psychiatry
  • Rehabilitation science

Background:

  • Workers' compensation and vocational rehabilitation programs aim to facilitate return to work for physically injured individuals.
  • Identifying predictors of successful return to work is essential for optimizing rehabilitation strategies.

Purpose of the Study:

  • To investigate predictors of returning to work in physically injured individuals receiving workers' compensation and vocational rehabilitation.
  • To determine the role of depression and other variables in return-to-work outcomes.

Main Methods:

  • A cohort of 114 physically injured subjects (86 back injury, 28 other) undergoing vocational rehabilitation were assessed.
  • Stepwise logistic regression was used to identify predictors of return to work.

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  • The Beck Depression Inventory (BDI) was a key measure of depressive symptoms.

    • Main Results:

    • Moderate to severe depression (BDI score > 16) was a significant predictor of failure to return to work (OR = 31 for back-injured patients).
    • BDI scores accurately classified return-to-work status for 84% of back-injured and 86% of other-injured groups.
    • Workers' compensation benefit level marginally improved the predictive power of the BDI.

    Conclusions:

    • Depressive symptoms are a strong predictor of return to work in physically injured individuals not deemed permanently disabled.
    • Treatment of depression is a critical component of vocational rehabilitation for injured workers.
    • Caution is advised when using the Beck Depression Inventory in forensic settings due to potential response bias.