title: A 2-year cohort study on the impact of an Employee Assistance Programme (EAP) on depression and suicidal thoughts in male Japanese workers.
abstract: OBJECTIVE
  Depression and suicide-related behaviours are important issues for workers, and the number of Japanese companies contracting with the Employee Assistance Programme (EAP) to promote employees' mental health has recently increased. However, no longitudinal studies have reported that the EAP maintains or improves the overall level of depression among employees qualitatively. Thus, we attempted to assess the impact of the EAP on depression and suicide-related behaviours in the workplace.
  
  
  METHODS
  A cohort study was conducted on 283 male Japanese employees aged 22-38 years at a Japanese information-technology company introducing the EAP. Because the privacy policy of the EAP service made it difficult to perform a randomised design in the workplace, 22 men working at an affiliated company without the EAP were used as a reference group. All the subjects completed the 17-item Hamilton Depression Scale (HAM-D) and Job Content Questionnaire (JCQ) consisting of job demands, control, and social support before the EAP was introduced to establish a baseline and after 2 years.
  
  
  RESULTS
  In the EAP group, the total HAM-D scores significantly decreased after the 2-year study period (P=0.0011); the changes in the scores of the five HAM-D items (i.e., suicidal thoughts, agitation, psychomotor retardation, guilt, and depressed mood) were significant. Specifically, 19 (86%) of the 22 workers with a positive response to the suicidal thoughts item (i.e., score >or= 1) at baseline reported that they no longer had suicidal thoughts (i.e., score=0) after the 2 year study period. No significant changes were observed in the reference group. The three JCQ scores were not significantly different between the baseline and after the 2 year study period in both groups.
  
  
  CONCLUSIONS
  Although further studies are needed, EAPs may be a promising strategy for maintaining the good mental health of workers.
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. mnakao@med.teikyo-u.ac.jp
authors.forename: Mutsuhiro
authors.initials: M
authors.lastname: Nakao
authors.forename: Mariko
authors.initials: M
authors.lastname: Nishikitani
authors.forename: Satoru
authors.initials: S
authors.lastname: Shima
authors.forename: Eiji
authors.initials: E
authors.lastname: Yano
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000208:ethnology / Q000523:psychology; D006801:Humans; D008297:Male; D008605:Mental Health Services; D016273:Occupational Exposure; D009786:Occupational Health Services; D015397:Program Evaluation; D013405:Suicide / Q000208:ethnology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014041:Tokyo; D000092864:Suicide Prevention