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The British Journal of Psychiatry (2003) 183: 507-513
© 2003 The Royal College of Psychiatrists

Pattern of antidepressant use and duration of depression-related absence from work

Carolyn S. Dewa, MPH, PhD

Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario

Jeffrey S. Hoch, PhD

Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario

Elizabeth Lin, PhD

Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto

Michael Paterson, MSc

Institute for Clinical Evaluative Sciences, Toronto, Ontario

Paula Goering, RN, PhD

Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

Correspondence: Dr Carolyn S. Dewa, Centre for Addiction and Mental Health, Health Systems Research and Consulting Unit, 250 College St, Toronto, Ontario M5T1R8, Canada. Tel: (416) 535 8501 ext. 4101; fax: (416) 979 4703; e-mail: carolyn_dewa{at}camh.net

Declaration of interest None.

Background Few studies have examined the relationship between antidepressant prescription and receipt of depression-related disability benefits.

Aims To address two questions: first, is prescription of antidepressants in accordance with published clinical guides associated with better disability outcomes, and second, what is the relationship between guideline-concordant antidepressant prescription and length of disability?

Method An observational study was conducted using administrative data from three major Canadian financial and insurance sector companies. Short-term disability and prescription drug claims records for 1996–1998 were linked for workers receiving depression-related short-term disability benefits during that time.

Results Recommended first-line agents and recommended doses were significantly associated with return to work ({chi}2=6.64, P<0.036). In addition, among those who returned to work, early intervention was significantly associated with a shortened disability episode (ß=-24.1; 95% CI -34.4 to -13.8).

Conclusions Depression-related workplace disability is a problem for which there is no simple solution. These results provide an additional piece to the puzzle of helping workers disabled by depression to return to work.


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