This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Original Research

Predictors of Long-Term Return to Work and Symptom Remission in Sick-Listed Patients With Major Depression

Hiske L. Hees, MSc; Maarten W. J. Koeter, PhD; and Aart H. Schene, MD, PhD

Published: August 15, 2012

Article Abstract

Objective: Although major depressive disorder (MDD) has substantial negative effects on work outcomes, little is known regarding how to promote a return to work (RTW) after MDD-related sickness absence. The present study aimed to examine predictors across multiple domains for long-term RTW in patients who are sick-listed because of their MDD, and to compare these with predictors for long-term symptom remission.

Method: Participants (n = 117) were diagnosed with MDD according to DSM-IV criteria, absent from work for at least 25% of their contract hours, and referred by occupational physicians to outpatient treatment. Long-term full RTW (working the full number of contract hours for at least 4 weeks) and long-term symptom remission (Hamilton Depression Rating Scale score ≤ 7) were examined during the 18-month follow-up. Potential predictors (diagnostic, sociodemographic, personality, and work-related) were assessed at baseline. Data were collected from December 2007 to March 2011.

Results: Stepwise logistic regression analyses with backward elimination (P .05) resulted in a final prediction model including depression severity (odds ratio [OR] = 0.92; 95% CI, 0.87-0.97; P = .003), comorbid anxiety (OR = 0.21; 95% CI, 0.05-0.84; P = .028), work motivation (OR = 1.87; 95% CI, 1.18-2.96; P = .008), and conscientiousness (OR = 1.10; 95% CI, 1.02-1.18; P = .012) as predictors of long-term RTW. Long-term symptom remission was only predicted by depression severity (OR = 0.93; 95% CI, 0.89-0.98; P = .005).

Conclusions: Whereas long-term symptom remission is only predicted by diagnostic factors, long-term RTW is also predicted by personal and work-related factors. These findings provide suggestions for the development of new interventions to improve both symptom remission and long-term RTW in sick-listed patients with MDD.

Trial Registration: Dutch Trial Register identifier: NTR2057

J Clin Psychiatry 2012;73(8):e1048-e1055

Submitted: February 5, 2012; accepted March 28, 2012 (doi:10.4088/JCP.12m07699).

Corresponding author: Hiske Hees, MSc, Academic Medical Center, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands (H.L.Hees@amc.uva.nl).

Volume: 73

Quick Links: Depression (MDD)

Continue Reading…

Subscribe to read the entire article

$40.00

Buy this Article as a PDF

Sign-up to stay
up-to-date today!

SUBSCRIBE

Already registered? Sign In

Clinical and Practical Psychopharmacology

Skeletal and Dental Fractures Associated With Electroconvulsive Therapy

Recent data suggest the risk of skeletal or dental fracture with ECT may be as low as...

Read More...