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Antidepressant treatment effective for work productivity in depression

Antidepressant treatment improved work productivity among individuals with major depression, according to recent findings.

“The long-term deleterious effects of greater depression severity on work are well known. As a baseline factor, being employed has been shown to predict better clinical outcomes. However, whether changes in work productivity affect the typically chronic or recurrent course of depression is unknown,” Manish K. Jha, MBBS, of University of Texas Southwestern Medical Center, Dallas, and colleagues wrote. “Our knowledge of the relationship between depressive symptoms and work productivity is also limited by the fact that most studies of work productivity improvement during antidepressant treatment have measured changes only between baseline and posttreatment.”

To determine the independent effect of antidepressant treatment on work productivity among individuals with depression, researchers evaluated 331 employed individuals with major depression enrolled in the Combining Medications to Enhance Depression Outcomes trial. Work productivity was assessed via the Work Productivity and Activity Impairment self-report questionnaire. Researchers used trajectories of change in productivity during the first 6 weeks of treatment to predict remission at 3 and 7 months.

Significant improvement in all work productivity outcomes occurred after 12 weeks of treatment.

The mean rate of self-reported absence from work decreased from 12.34 hours at baseline to 4.17 hours at 12 weeks (P < .0001).

The mean rate of presenteeism (ie, percent of impairment while at work) decreased from 40.4 hours at baseline to 19.8 hours at 12 weeks (P < .0001).

The mean rate of work productivity loss decreased from 44.9 hours at baseline to 21 hours at week 12 (P < .0001).

These associations remained significant after controlling for changes in depression severity.

Researchers found three distinct trajectories of change in work productivity. Robust early improvement occurred in 24% of participants; minimal change occurred in 49% of participants; and high-impairment slight reduction occurred in 27% of participants.

Participants with early robust improvement had remission rates three to five times higher at 3 months and two to five times higher at 7 months, compared with other participants.

These associations remained significant when controlling for baseline variables and remission status at week 6.

“We found that work productivity improved with acute-phase antidepressant treatment even after accounting for change in depression severity and self-reported cognitive functioning. Secondly, the trajectories of this improvement in work productivity predicted long-term changes in depression severity and remission status,” the researchers wrote. “These findings highlight the multidimensional improvement with antidepressant treatment and argue for inclusion of work productivity assessments in routine clinical practice.” – by Amanda Oldt

Disclosure: Jha reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.