The British Journal of Psychiatry
Pattern of antidepressant use and duration of depression-related absence from work
Carolyn S. Dewa, Jeffrey S. Hoch, Elizabeth Lin, Michael Paterson, Paula Goering

Abstract

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 (χ2=6.64, P<0.036). In addition, among those who returned to work, early intervention was significantly associated with a shortened disability episode (β=-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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