Researchers at the University of Texas Southwestern Medical Center in Dallas report that productivity in the work place is enhanced when individuals who are depressed receive early treatment for their symptoms. They also report that individuals that receive late stage treatment for depression continue to have a decrease in productivity. A Sequenced Treatment Alternatives to Relieve Depression (STAR*D) was used to collect and analyze data. Information on this study was published in the American Journal of Psychiatry (June, 2013).
According to the principal investigator Madhukar Trivedi, MD, “When people have depression and their work productivity suffers, it is mainly related to the fact that their symptoms are preventing them from accomplishing their best at work.” Trivedi also reports that when depression recovery is only partial, depression continues and has an overall effect on interactions with coworkers and work productivity. Moreover, even if depressed individuals go into remission with continued therapy, work productivity does not return to normal.
The loss of work productivity creates a financial burden on U.S. employers to the tune of $225 billion, and about 66 percent of this is contributed to depression. The loss of healthy social interactions due to loss in cognitive function brings about a loss in work productivity along with psychosocial functioning. Currently, the relationship between sociodemographic and clinical factors with pretreatment is not understood. This study was conducted to establish a baseline for these sociodemographic and clinical characteristics associated with outpatients who are depressed.
Depressed outpatients between the ages of 18 and 75 years participated in the STAR*D study. These patients received 20-40 mg of citalopram daily. Patients who did not recover from their depression were given sertraline, buproprion (sustained-release) or venlafaxine (extended-release) as a level 2 therapy. As an alternative, bupropion (sustained-release) or buspirone could be augmented as a level 2 therapy. Patients were analyzed for clinical and demographic qualities and therapeutic outcomes to determine a relationship to baseline work productivity and changes in productivity with time.
Work productivity was self-reported. The number of hours missed within a 7-day period was used as an Activity Impairment scale along with hours worked within the past 7 days. Impairment that resulted from depression was also reported. These researchers found that work productivity improved by several factors during level 1 treatment resulting in a decrease in the severity of depression. Unfortunately, these results did not pan out for level 2 therapies. In fact, they found an association between more impaired work productivity and increased levels of anxiety.
According to Trivedi, “The majority of studies focus on symptom improvement, not functional improvement, but a good outcome includes improvement in both symptoms and a return to previous levels of functioning.” These researchers feel that for patients whose depression subsides, work productivity needs to be assessed along with other strategies such as exercise activities and/or cognitive behavioral treatment. This would provide for more definitive functional improvements.
At the moment, it is known that individuals with therapy-resistant depression carry the highest financial burden to employers so it is crucial to achieve early remission not only for employers but employees as well.