The presence of a depressive episode predicts lower return to work rate after myocardial infarction.
BACKGROUND
No studies have evaluated whether the presence of a depressive episode is associated with an increased risk of not returning to work following myocardial infarction (MI).


OBJECTIVE
To examine the prospective associations between depressive episode and anxiety disorders with return to work (RTW) after MI at 3 and 12 months based on International Classification of Diseases, 10th Revision.


METHODS
Prospective cohort study.


METHODS
Four hospitals in the North of The Netherlands.


METHODS
From a sample of patients hospitalized for MI (n=487), we selected those who had a paid job at the time of the MI (N=200).


METHODS
Presence of a depressive episode and presence of any anxiety disorder during the first 3 months post-MI.


METHODS
RTW at 12 months post-MI.


RESULTS
Of the patients with work prior to MI, 75% had returned to work at 12 months. The presence of a depressive episode during the first 3 months (prevalence: 19.4%) was a significant predictor of no RTW at 12 months post-MI, also after controlling for confounders [odds ratio (OR) 3.48; 95% confidence interval (CI): 1.45-8.37]. The presence of an anxiety disorder (prevalence: 11.9%) had a borderline significant association with no RTW as well. This association remained after controlling for confounders (OR 2.90; 95% CI: 1.00-6.38) but diminished when controlling for depression.


CONCLUSIONS
The presence of a depressive episode was associated with an increased risk of no RTW in MI patients. The association between anxiety and risk of no RTW could in part be explained by the presence of depression. Further studies may address the possibility of countering the effect of depression by effective treatment.
Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands. Electronic address: peter.de.jonge@umcg.nl.
Peter
P
de Jonge
Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands.
Marij
M
Zuidersma
Division of Community and Occupational Medicine, Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands.
Ute
U
Bültmann
D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000523:psychology; D009426:Netherlands; D015995:Prevalence; D011446:Prospective Studies; D062707:Return to Work / Q000706:statistics & numerical data*; D013997:Time Factors
Anxiety; Depression; Myocardial infarction; Return to work