The effect of remission status on work functioning in employed patients treated for major depressive disorder

BACKGROUND: The ability to function at work is impaired inpatients with major depressive disorder (MDD) but few-clinical trials include occupational outcome assessments.-This study examined whether symptom remission following treatment for MDD is associated with work functioning improvement. METHODS: We conducted a secondary analysis of a 12-week.randornized clinical trial comparing escitaloprani with or without telephone-administered cognitive therapy in employed patients with MDD (N = 86). Outcomes included the Montgomery,-Asb erg Depression- Rating Scale (MADRS) and validated, self-rated work functioning- scales including the Lam Employment Absence and Productivity Scale (LEAPS); Work Performance Questionnaire (HPQ), and Sheehan Disability Scale (SDS). RemissiOn was defined as MADRS score <10 at 12-weeks: Data were evaluated using analysis of covariance with baseline score as covariates. - RESULTS: Remission status was associated with significant improvement in work performance as assessed by the LEAPS productivity subscale, HPQ overall performance, and the SDS work/school item; a trend (P =.08) was observed with the HPQ productivity subscale. The effect sizes (d = 0.23, - 0.5131136, and 0.43, respectively) indicate small to medium effects that are likely clinically significant. CONCLUSIONS: The results of our study confirm that symptom remission. following treatment is associated significantly with improvement in work performance and productivity,,as measured by validated work functioning scales, Measurement-based care for MDD should include bath symptom and functional outcome assessments.