Pattern of antidepressant use and duration of depression-related absence from work.
BACKGROUND
Few studies have examined the relationship between antidepressant prescription and receipt of depression-related disability benefits.


OBJECTIVE
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?


METHODS
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 (beta=-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.
Dewa
Carolyn S
CS
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. carolyn_dewa@camh.net
Hoch
Jeffrey S
JS
Lin
Elizabeth
E
Paterson
Michael
M
Goering
Paula
P
D000041:Absenteeism; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D017410:Practice Guidelines as Topic; D012044:Regression Analysis; D012720:Severity of Illness Index; D012737:Sex Factors; D012943:Social Security; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
D000928:Antidepressive Agents