Longitudinal relationship between depressive symptoms and work outcomes in clinically treated patients with long-term sickness absence related to major depressive disorder

Abstract

BackgroundMajor depressive disorder (MDD) negatively affects a wide range of work outcomes (absenteeism, work productivity, work limitations). However, the exact longitudinal relationship between depressive symptoms and work outcomes in MDD patients with long-term sickness absence is still unclear. Therefore, the present study aimed to examine the temporal and directional relationship between depressive symptoms and various work outcomes in these patients. MethodsPatients (n=117) were diagnosed with MDD according to DSM-IV criteria, had a median duration of MDD-related sickness absence of 4.8 months (IQR=2.6–10.1 months) at baseline, and were referred by occupational physicians. All patients received outpatient treatment for their MDD. Depressive symptoms and work outcomes were examined during baseline, and 6-, 12- and 18-month follow-ups. ResultsWithin-subject changes in the severity of depressive symptoms were significantly related to within-subject changes in all work outcomes (all scales: p<0.001). Earlier reduction in depressive symptoms predicted subsequent improvements in all work outcomes (all scales: p<0.05). Conversely, only earlier improvement in Time Management (p=0.007) and Mental/Interpersonal (p<0.001) work limitations predicted a subsequent reduction in depressive symptoms. LimitationsAll work outcomes were assessed through self-report. Work limitations at the start of absenteeism were retrospectively assessed. ConclusionsSymptom reduction remains crucial for improving adverse work outcomes in MDD patients with long-term sickness absence. In addition, a treatment focus on qualitative functioning in the workplace may accelerate depression recovery.