title: Longitudinal relationship between depressive symptoms and work outcomes in clinically treated patients with long-term sickness absence related to major depressive disorder.
abstract: BACKGROUND
  Major 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.
  
  
  METHODS
  Patients (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.
  
  
  RESULTS
  Within-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.
  
  
  CONCLUSIONS
  All work outcomes were assessed through self-report. Work limitations at the start of absenteeism were retrospectively assessed.
  
  
  CONCLUSIONS
  Symptom 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.
authors: Program for Mood Disorders (PA 3.223), Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands. H.L.Hees@amc.uva.nl
authors: Hiske L
authors: HL
authors: Hees
authors: Maarten W J
authors: MW
authors: Koeter
authors: Aart H
authors: AH
authors: Schene
mesh_terms: D000041:Absenteeism; D000328:Adult; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy; D004526:Efficiency; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014937:Work / Q000523:psychology*