High status job may hinder depression treatment response

Individuals with depression who were in higher occupational levels had poorer treatment response and higher rates of treatment-resistant depression, according to findings presented at the European College of Neuropsychopharmacology Congress.

“Though these findings should be considered preliminarily, they indicate that high occupational levels may be a risk factor for poor response to treatment,” study researcher Siegfried Kasper, MD, of the Medical University of Vienna, Austria, said in a press release. “A number of variables may explain these findings. For example, there may be specific working environment demands and stressors; people may find it difficult to accept or cope with illness, or to continue with medication; or there may be other factors, related for example to cognitive, personality and behavioral differences.”

To assess associations between occupational level and depression treatment outcomes, researchers evaluated a large multinational sample of working individuals with depression who received at least one adequate treatment trial (n = 654). Study participants were stratified in three occupational levels (high, middle, and low).

Individuals in the high occupational level who had depression were younger, more educated and more likely to have received additional psychotherapy, compared with individuals with depression in other occupational levels. However, those in the high occupational level exhibited poorer response to last depression treatment and higher rates of treatment-resistant depression, compared with those in other occupational levels.

Eduard Vieta

Sociodemographic and treatment-related factors did not influence study findings, according to researchers.

“The results of this study might sound counterintuitive, but people with highly demanding jobs are subject to a lot of stress, and when they break down with depression it may be particularly difficult to cope with their previous life. An alternative explanation, which cannot be ruled out given the naturalistic design of the study, is that high-status job patients may be more prone to request psychosocial treatments without the support of pharmacotherapy,” Eduard Vieta, PhD, treasurer of the European College of Neuropsychopharmacology, said in the release. “The ideal treatment of depression is, in general, the combination of both pharmacotherapy and psychotherapy.” – by Amanda Oldt

Reference:

Mandelli L, et al. High occupational level is associated with poor response to treatment of depression. Presented at: European College of Neuropsychopharmacology Congress; September 17-20, 2016; Vienna.

Disclosure: The study was funded by the Expert Platform on Mental Health focus on Depression.