title: Relationships between mood and employment over time among depressed VA primary care patients.
abstract: OBJECTIVE
  Associations between depression, productivity and work loss have been reported, yet few studies have examined relationships between longitudinal depression status and employment continuity. We assessed these relationships among Veterans of conventional working ages.
  
  
  METHODS
  We used longitudinal survey data from Veterans receiving primary care in 1 of 10 Veterans Health Administration primary care practices in five states. Our sample included 516 participants with nine-item Patient Health Questionnaire (PHQ-9) scores indicating probable major depression (PHQ-9≥10) at baseline and who completed either the 7-month follow-up survey or follow-up surveys at both 7 and 18 months postbaseline. We examined relationships between depression persistence and employment status using multinomial logistic regression models.
  
  
  RESULTS
  Although general employment rates remained stable (21%-23%), improved depression status was associated with an increased likelihood of becoming employed over 7 months among those who were both depressed and nonemployed at baseline. Improvements in depression status starting at 7 months and continuing through 18 months were associated with remaining employed over the 18-month period, relative to those who were depressed throughout the same time frame.
  
  
  CONCLUSIONS
  Given the pressing need to prevent socioeconomic deterioration in the increasing population of conventional working-aged Operation Enduring Freedom and Operation Iraqi Freedom Veterans, further attention to the depression/employment relationship is urgently needed.
authors: Veterans Affairs Ann Arbor, National Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), HSR&D, USA. kzivin@umich.edu
authors: Kara
authors: K
authors: Zivin
authors: Duncan G
authors: DG
authors: Campbell
authors: Andrew B
authors: AB
authors: Lanto
authors: Edmund F
authors: EF
authors: Chaney
authors: Cory
authors: C
authors: Bolkan
authors: Laura M
authors: LM
authors: Bonner
authors: Erin M
authors: EM
authors: Miller
authors: Marcia
authors: M
authors: Valenstein
authors: Thomas J
authors: TJ
authors: Waltz
authors: Lisa V
authors: LV
authors: Rubenstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000523:psychology*; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D055815:Young Adult