TY - JOUR T1 - Psychotherapy and change in mental health-related work disability: a prospective Finnish population-level register-based study with a quasi-experimental design JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health DO - 10.1136/jech-2022-218941 SP - jech-2022-218941 AU - Johanna Kausto AU - Kia Gluschkoff AU - Jarno Turunen AU - Sanna Selinheimo AU - Laura Peutere AU - Ari Väänänen Y1 - 2022/09/16 UR - http://jech.bmj.com/content/early/2022/09/16/jech-2022-218941.abstract N2 - Background Mental disorders are a major cause of work disability among the working-age population. Psychotherapy has shown to be an effective treatment for mental disorders, but the evidence is mainly based on small-scale randomised trials with relatively short follow-ups. We used population-based register data to examine the association between statutory rehabilitative psychotherapy and change in depression or anxiety-related work disability.Methods We drew a nationally representative sample of the working-age population (aged 18–55 in 2010). The study group comprised all those who started rehabilitative psychotherapy in 2011–2014. A total of 10 436 participants who were followed from 3 years prior to 4 years after the onset of rehabilitative psychotherapy. This resulted in 83 488 observations. The annual total number of mental health-related work disability months (0 to 12) was calculated from the total number of annual compensated sickness absence and disability pension days. A quasi-experimental interrupted time series analysis was applied.Results The onset of rehabilitative psychotherapy marked a decline in work disability in comparison to the counterfactual trend. Specifically, a 20% decrease in the level (incidence rate ratio, IRR 0.80; 95% CI 0.76 to 0.85) and a 48% decrease in the slope (IRR 0.52; 95% CI 0.50 to 0.54) of work disability were detected in comparison to the counterfactual scenario. No significant gender differences were observed. The decline in work disability was the steepest in the oldest age group.Conclusions This study suggests that statutory psychotherapy may decrease work disability at the population level. However, further evidence of causal inference and the potential heterogeneity of the association is required.No data are available. No additional data are available because of Finnish legislation. Only researchers with the permission of the Finnish Social and Health Data Permit Authority and Statistics Finland have access to the analysed data. ER -