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Psychological morbidity and return to work after injury: Multicentre cohort study

Kendrick, Denise; Dhiman, Paula; Kellezi, Blerina; Coupland, Carol; Whitehead, Jessica; Beckett, Kate; Christie, Nicola; Sleney, Jude; Barnes, Jo; Joseph, Stephen; Morriss, Richard


Denise Kendrick

Paula Dhiman

Blerina Kellezi

Carol Coupland

Jessica Whitehead

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Kate Beckett
Occasional Associate Lecturer - Allied Health Professions

Nicola Christie

Jude Sleney

Jo Barnes

Stephen Joseph

Richard Morriss


© British Journal of General Practice. Background The benefits of work for physical, psychological, and financial wellbeing are well documented. Return to work (RTW) after unintentional injury is often delayed, and psychological morbidity may contribute to this delay. The impact of psychological morbidity on RTW after a wide range of unintentional injuries in the UK has not been adequately quantified. Aim To quantify the role of psychological factors, including anxiety, depression, and post-Traumatic distress, on RTW following unintentional injuries. Design and setting A longitudinal multicentre prospective study was undertaken in Nottingham, Bristol, Leicester, and Guildford, UK. Method Participants (n = 273) were 16-69-year-olds admitted to hospital following unintentional injury, who were in paid employment prior to injury. They were surveyed at baseline, then at 1, 2, 4, and 12 months following injury; demographic data were collected along with injury characteristics, psychological morbidity, and RTW status. Associations between demographic, injury and psychological factors, and RTW between 2 and 12 months after injury were quantified using random effects logistic regression. Results The odds of RTW between 2 and 12 months after injury reduced as depression scores early in the recovery period (1 month after injury) increased (odds ratio [OR] 0.87, 95% confidence interval [CI] = 0.79 to 0.95) and as length of hospital stay increased (OR 0.91, 95% CI] = 0.86 to 0.96). For those experiencing threatening life events following injury (OR 0.27, 95% CI = 0.10 to 0.72) and with higher scores on the Crisis Support Scale (OR 0.93, 95% CI] = 0.88 to 0.99), the odds of RTW between 2 and 12 months after injury were lower. Multiple imputation analysis found similar results, but those relating to crisis support did not remain statistically significant. Conclusion Primary care professionals can identify patients at risk of delayed RTW who may benefit from management of psychological morbidity and support to RTW.


Kendrick, D., Dhiman, P., Kellezi, B., Coupland, C., Whitehead, J., Beckett, K., …Morriss, R. (2017). Psychological morbidity and return to work after injury: Multicentre cohort study. British Journal of General Practice, 67(661), e555-e564.

Journal Article Type Article
Acceptance Date Jan 22, 2017
Publication Date Aug 1, 2017
Journal British Journal of General Practice
Print ISSN 0960-1643
Electronic ISSN 1478-5242
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Volume 67
Issue 661
Pages e555-e564
Public URL
Publisher URL


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