Multiple psychiatric diagnoses and return-to-work following posttraumatic stress injury rehabilitation

Article type: Research Article

Authors: Krebs, Brandon K.^{a; *} | Rachor, Geoffrey S.^b | Yamamoto, Shelby S.^c | Dick, Bruce D.^d | Brown, Cary A.^e | Asmundson, Gordon J.G.^b | Straube, Sebastian^{c; f} | Els, Charl^g | Jackson, Tanya D.^f | Brémault-Phillips, Suzette^e | Voaklander, Don^c | Stastny, Jarett^h | Berry, Theodore^h | Gross, Douglas P.ⁱ

Affiliations: [a] Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada | [b] Department of Psychology, University of Regina, Regina, Canada | [c] School of Public Health, University of Alberta, Edmonton, Canada | [d] Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada | [e] Department of Occupational Therapy, University of Alberta, Edmonton, Canada | [f] Department of Medicine, Division of Preventive Medicine, University of Alberta, Edmonton, Canada | [g] Department of Psychiatry, University of Alberta, Edmonton, Canada | [h] Workers Compensation Board of Alberta, Edmonton, Canada | [i] Department of Physical Therapy, University of Alberta, Edmonton, Canada

Correspondence: [*] Address for correspondence: Brandon Krebs, 2–50 Corbett Hall, University of Alberta, Edmonton, Alberta T6G 2G4, Canada. E-mail: [email protected].

Abstract: BACKGROUND: Posttraumatic stress injury (PTSI) is a term used to describe a range of psychiatric difficulties which arise following exposure to a psychologically traumatic event. The impact of being diagnosed with multiple psychiatric conditions on the return-to-work (RTW) outcomes of individuals with PTSI has not been adequately researched. OBJECTIVE: The current study examined whether the presence of two or more psychiatric conditions occurring simultaneously is predictive of RTW outcomes in workers with PTSI. METHOD: A population-based cohort design was conducted using archival data from injured workers admitted to a PTSI rehabilitation program. Differences in RTW outcomes and demographic, administrative, and clinical variables were compared between individuals with single and multiple psychiatric diagnoses. A range of variables were entered into a multivariable logistic regression model predicting RTW. RESULTS: The final logistic regression model indicated workers had higher odds of RTW if they had a single psychiatric diagnosis (Adjusted Odds Ratio (AOR) 2.20), non-elevated scores on a measure of traumatic stress (AOR 1.85), and reported higher self-perceived readiness to RTW (AOR 1.24). CONCLUSION: Being diagnosed with multiple psychiatric conditions appears to be associated with more negative RTW outcomes following PTSI rehabilitation.

Keywords: Rehabilitation, posttraumatic stress injury, return-to-work, workers’ compensation, compensation and duress

DOI: 10.3233/JVR-230063

Journal: Journal of Vocational Rehabilitation, vol. 60, no. 3, pp. 363-377, 2024