Abstract
Objective. To evaluate the effect of an early vocational-orientated eclectic intervention on beck depression inventory (BDI) scores compared to treatment as usual in first ever depressive episode among employed people. Design. A randomized controlled trial comparing the rehabilitative intervention and the conventional treatment. Subjects. The subjects came from occupational health care units. Methods. Employees were sent to a rehabilitation center after being screened for depression using the BDI. They were diagnosed using the structured clinical interview for DSM-IV. The participating subjects (N = 283) were randomized into intervention and control groups. The intervention group received eclectic early depression intervention treatment (N = 134) and the control group was treated in the conventional way (N = 100). They were followed for one year. Results. The mean decrease in BDI scores within the intervention group was from 20.8 to 11.6 and within the control group from 19.3 to 10.8. BDI score decreased by 10 or more points in 64% of the participants in the intervention group and in 53% of the control group (P = 0.013). Conclusions. There was some evidence that early eclectic intervention in first ever episode depression may be more effective than conventional treatments among working age people in employment.
Highlights
Depression is a common psychiatric disorder characterized by high rates of relapse and recurrence [1]
To evaluate the effect of an early vocational-orientated eclectic intervention on beck depression inventory (BDI) scores compared to treatment as usual in first ever depressive episode among employed people
A two-phase rehabilitation program was used for the intervention group; the control group received treatment as usual (TAU)
Summary
Depression is a common psychiatric disorder characterized by high rates of relapse and recurrence [1]. According to the STAR∗ D study, the overall cumulative remission rate when using antidepressive medication in the treatment of major depressive disorder (MDD), after four treatment steps, was less than 70% [2]. A review by Baumeister and Hutter [3] concluded that single interventions have little effect on outcomes in depressive patients. Collaborative care interventions that focus on the work and family relations of an individual, and involve occupational health care workers and staff from psychiatric and psychological facilities, are efficacious in patients with depression. A systematic review by Furlan et al [4] concluded that there is insufficient evidence to determine which interventions are effective in managing depression in the workplace
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