A 5-year prospective study of predictors for functional and work disability among primary care patients with depressive disorders.
OBJECTIVE
To study prevalence of and predictors for functional and work disability among primary care (PC) patients with depressive disorders in prospective long-term follow-up.


METHODS
The Vantaa Primary Care Depression Study followed up prospectively 137 patients with depressive disorders for 5 years with a life chart. Information on level of functioning in general and in different dimensions, employment, sick leaves and disability pensions were obtained from interviews and patient records.


RESULTS
Level of functioning and work ability were strongly associated with time spent depressed and/or current severity of depression. Patients who belonged to the labour force at baseline spent one-third of the follow-up off work due to depression; two-thirds were granted sick leaves, and one-tenth a disability pension due to depression. Longer duration of depression, co-morbid disorders and having received social assistance predicted dropping out from work.


CONCLUSIONS
Duration of depressive episodes appears decisive for long-term disability among PC patients with depression. Patients spent one-third of the follow-up off work due to depression, and remaining outside the labour force is a common outcome. Psychiatric and somatic co-morbidities, education and socio-economic means influence the level of functioning and ability to work, but are not equally important for all areas of life.
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FIN-00270 Helsinki, Finland. Electronic address: kirsi.riihimaki@fimnet.fi.
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K
Riihimäki
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FIN-00270 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, P.O. Box 590, 00029 Helsinki, Finland. Electronic address: maria.vuorilehto@kolumbus.fi.
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M
Vuorilehto
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FIN-00270 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, P.O. Box 590, 00029 Helsinki, Finland; Institute of Clinical Medicine, Department of Psychiatry, P.O. Box 22 (Välskärinkatu 12 A), 00014 University of Helsinki, Helsinki, Finland. Electronic address: erkki.isometsa@hus.fi.
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Isometsä
D000328:Adult; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D006233:Persons with Disabilities; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010415:Pensions; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012179:Retirement; D018582:Sick Leave; D013997:Time Factors
Depressive disorders; Disability; Major depression; Primary care; Work disability