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


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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