Work disability following workplace back and upper extremity strain and sprain: incidence and impact of depressive and anxiety disorders

Project number: 
16-166
Approval date: 
Friday, September 30, 2016
Principal Investigator: 
Jones,Andrea
Institution: 
University of British Columbia (UBC)
Funding Agency: 
WorkSafeBC
Datasets requested: 
Hospital Separations (BC Ministry of Health)
WorkSafe BC Claims Files and Firm Level Data
Consolidation - demographic (Ministry of Health)
PharmaNet
Consolidation registry (Ministry of Health)
Medical Services Plan (BC Ministry of Health)
consolidation - census geocodes
Research objective: 

The overall goal of the current research is to examine depressive and anxiety disorders during work disability following workplace musculoskeletal (MSK) strain or sprain. The specific research objectives are to examine:
1) The rates and distribution of depression and anxiety disorders before and after injury, as well as by demographic, workplace, clinical, and injury characteristics amongst workers with an accepted workplace, time loss MSK injury claim.
2) The impact of pre-existing and new onset depressive and anxiety disorders on the type and timing of the final return to work outcome among workers with an accepted workplace time loss MSK injury claim.
3) The impact of modified return to work on type and timing of the final return to work outcome amongst workers with an accepted workplace, time loss MSK injury claim; and to examine if co-morbid depression or anxiety disorders modify this relationship.
4) The impacts of depressive and anxiety disorders on probability of transitions between return to work states (e.g. from short term disability to modified return to work or vice versa).

First, we hypothesize that the risk of depressive and anxiety disorders will be greater in the post-injury time period compared to the pre-injury time period. In addition, we hypothesize that the following factors will be associated with an increased risk of depression or anxiety: female gender, older age, lower income, manual labour, geographic location, co-morbid chronic physical conditions, poor employer experience rating, and workplaces with a small number of employees. Second, we hypothesize that amongst workers with workplace musculoskeletal injury, depressive and anxiety disorders will delay time until full sustained return to work, compared to workers without comorbid depressive or anxiety disorders. Also, we hypothesize that the combined effects of depression and anxiety disorders on return to work outcomes will be greater than that expected based on the effects of each condition alone. Third, we hypothesize that modified return to work will increase the probability of transition to full sustained return to work for injured workers with and without co-morbid depressive and/or anxiety disorders. We also hypothesize that use of modified return to work will reduce prolonged claim durations attributable to comorbid depressive and anxiety disorders; thus reducing the differential in time to full sustained return to work between individuals with workplace MSK injury and a comorbid depressive and/or anxiety disorder and those with just a workplace MSK injury. Fourth we hypothesize that both depressive and anxiety disorders will negatively impact transitions between return to work states that progressively lead to full sustained return to work; while also positively impacting transitions between return to work states that progressively lead to no return to work.


Page last revised: December 5, 2017