Gestão baseada em evidências do retorno ao trabalho nos transtornos mentais comuns: um roteiro para a prática intervencionista e a coordenação do processo
DOI:
https://doi.org/10.25118/2763-9037.2026.v16.1653Palavras-chave:
Retorno ao Trabalho, Transtornos Mentais, Licença Médica, Reabilitação, Saúde OcupacionalResumo
Introdução: Os transtornos mentais comuns figuram entre as principais causas de afastamento laboral prolongado, e sua incidência cresce de forma acelerada, inclusive no Brasil. Persiste uma dissociação entre a melhora dos sintomas e o retorno efetivo e sustentável ao trabalho. Objetivo: Sintetizar criticamente as evidências sobre a gestão do retorno ao trabalho de pessoas afastadas por transtornos mentais comuns e propor um roteiro prático, intervencionista e coordenado. Método: Revisão narrativa crítica com busca em seis bases (MEDLINE/PubMed, Embase, PsycINFO, Scopus, Web of Science e LILACS), abrangendo os últimos dez anos, orientada pelos critérios SANRA para avaliação de revisões narrativas, com síntese temática e caracterização prudente da força das evidências. Resultados: As expectativas e a autoeficácia do trabalhador predizem o desfecho de forma robusta, por vezes acima da gravidade diagnóstica. O ambiente psicossocial do trabalho prediz o retorno mesmo após ajuste para sintomas. O contato estruturado com o local de trabalho e as intervenções focadas no trabalho reduzem o tempo até o retorno, enquanto a melhora clínica isolada é insuficiente. O retorno é heterogêneo, com trajetórias distintas e risco relevante de recaída. A coordenação de caso e as ferramentas digitais são promissoras, com base ainda incipiente. Conclusão: A gestão eficaz exige deslocar o foco da remissão de sintomas para a recuperação funcional, a adequação das demandas e a coordenação entre os atores, com validação local das recomendações.
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Copyright (c) 2026 Sarha Andrade Lobo de Queiroz, Renata Nayara da Silva Figueiredo, Silvia Stahl Merlin
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