Systematic review: Effect of psychiatric symptoms on return to work after occupational injury

Background: Although post-traumatic stress disorder (PTSD) and depression are commonly observed following injury, few studies have focused on the effect of psychiatric symptoms on return to work (RTW) following occupational injury. Aims: To determine the impact of psychiatric symptoms on RTW after occupational injury.Methods: PubMed (1980-2014), MEDLINE (1980-2014) and PsycINFO (1980-2014) databases were examined with linked fields of research in February 2015. Reference lists of eligible articles were also searched. Cohort, case-control, cross-sectional studies and intervention studies were selected according to predefined criteria. Evidence was synthesized qualitatively according to the Downs and Black and Crombie checklist. The standard checklist was used to assess the methodological quality of each study by two reviewers. Results: Five of the 56 records met the inclusion and exclusion criteria. After occupational injury, the rates of RTW after the injuries varied widely, ranging from 31 to 63%. PTSD symptoms and depressive symptoms appeared to be negatively associated with RTW. Conclusions: Currently, the evidence is insufficient to draw conclusions about the effects of psychiatric symptoms on RTW after occupational injury and more studies are needed. Future studies with large sample sizes are warranted to determine the prevalence of RTW and to detect the psychiatric factors.