Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-10T14:12:54.512Z Has data issue: false hasContentIssue false
  • English
  • Français

A 5-year prospective study of predictors for functional and work disability among primary care patients with depressive disorders

Published online by Cambridge University Press:  15 April 2020

K. Riihimäki ,
M. Vuorilehto  and
E. Isometsä
K. Riihimäki
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FIN-00270 Helsinki, Finland
M. Vuorilehto
Affiliation:
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
E. Isometsä*
Affiliation:
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), 00014University of Helsinki, Helsinki, Finland
*
⁎Corresponding author. E-mail address:kirsi.riihimaki@fimnet.fi (K. Riihimäki), maria.vuorilehto@-kolumbus.fi (M. Vuorilehto), erkki.isometsa@hus.fi, erkki.isometsa@helsinki.fi (E. Isometsä).
Get access

Abstract

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.

Conclusion:

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.

Keywords

Primary careDepressive disordersMajor depressionDisabilityWork disability
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 1 , January 2015 , pp. 51 - 57
Copyright
Copyright © Elsevier Masson SAS 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahola, K, Virtanen, M, Honkonen, T, Isometsä, E, Aromaa, A, Lönnqvist, J. Compensated sickness absence in relation to depressive disorders – results from the Finnish Health 2000 Study. Finn Med J 2009;64(38):3081–3088.Google Scholar
Beck, A Cognitive therapy of depression 1979Google Scholar
Beck, AT, Weissman, A, Lester, D, Trexler, L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974;42(6):861–865.CrossRefGoogle ScholarPubMed
Beck, AT, Epstein, N, Brown, G, Steer, RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56(6):893–897.CrossRefGoogle ScholarPubMed
Birnbaum, HG, Kessler, RC, Kelley, D, Ben-Hamadi, R, Joish, VN, Greenberg, PE. Employer burden of mild, moderate, and severe major depressive disorder: mental health services utilization and costs, and work performance. Depress Anxiety 2010;27(1):78–89.CrossRefGoogle ScholarPubMed
Blumenthal, JA, Burg, MM, Barefoot, J, Williams, RB, Haney, T, Zimet, G. Social support, type A behavior, and coronary artery disease. Psychosom Med 1987;49(4):331–340.CrossRefGoogle ScholarPubMed
Broadhead, WE, Blazer, DG, George, LK, Tse, CK. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 1990;264(19):2524–2528.CrossRefGoogle Scholar
Bultmann, U, Christensen, KB, Burr, H, Lund, T, Rugulies, R. Severe depressive symptoms as predictor of disability pension: a 10-year follow-up study in Denmark. Eur J Public Health 2008;18(3):232–234.CrossRefGoogle ScholarPubMed
Ebrahim, S, Montoya, L, Truong, W, Hsu, S, Kamal El Din, M, Carrasco-Labra, A, et al.Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. PLoS One 2012;7(11):e50202.CrossRefGoogle ScholarPubMed
First, MB, Gibbon, M, Spitzer, RL, Williams, JBW, Benjamin, LSStructured Clinical Interview for DSM-IV Axis II Personality Disorders, (SCID-II). Washington, D.C.: American Psychiatric Press, Inc.;1997.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBWStructured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version. Patient Edition With Psychotic Screen. New York: New York State Psychiatric Institute;2002.Google Scholar
Goldman, HH, Skodol, AE, Lave, TR. Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 1992;149(9):1148–1156.Google ScholarPubMed
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62CrossRefGoogle ScholarPubMed
Holma, IA, Holma, KM, Melartin, TK, Rytsala, HJ, Isometsa, ET. A 5-year prospective study of predictors for disability pension among patients with major depressive disorder. Acta Psychiatr Scand 2012;125(4):325–334.CrossRefGoogle ScholarPubMed
Isometsa, ET, Katila, H, Aro, T. Disability pension for major depression in Finland. Am J Psychiatry 2000;157(11):1869–1872.CrossRefGoogle ScholarPubMed
Karpansalo, M, Kauhanen, J, Lakka, TA, Manninen, P, Kaplan, GA, Salonen, JT. Depression and early retirement: prospective population based study in middle-aged men. J Epidemiol Community Health 2005;59(1):70–74.CrossRefGoogle ScholarPubMed
Katon, W. The impact of depression on workplace functioning and disability costs. Am J Manag Care 1511 Suppl2009 S322S327Google ScholarPubMed
Kruijshaar, ME, Hoeymans, N, Bijl, RV, Spijker, J, Essink-Bot, ML. Levels of disability in major depression: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). J Affect Disord 2003;77(1):53–64.CrossRefGoogle Scholar
Lagerveld, SE, Bultmann, U, Franche, RL, van Dijk, FJ, Vlasveld, MC, van der Feltz-Cornelis, CM, et al.Factors associated with work participation and work functioning in depressed workers: a systematic review. J Occup Rehabil 2010;20(3):275–292.CrossRefGoogle ScholarPubMed
Lerner, D, Henke, RM. What does research tell us about depression, job performance, and work productivity?. J Occup Environ Med 2008;50(4):401–410.CrossRefGoogle ScholarPubMed
Lerner, D, Adler, DA, Chang, H, Lapitsky, L, Hood, MY, Perissinotto, C, et al.Unemployment, job retention, and productivity loss among employees with depression. Psychiatr Serv 2004;55(12):1371–1378.CrossRefGoogle ScholarPubMed
Murray, CJ, Vos, T, Lozano, R, Naghavi, M, Flaxman, AD, Michaud, C, et al.Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012;380(9859):2197–2223.CrossRefGoogle ScholarPubMed
NICE, Depression: the NICE Guideline on the treatment and management of depression in adults London: National Institute for Health and Clinical Excellence;2010.Google Scholar
Nieuwenhuijsen, K, Bultmann, U, Neumeyer-Gromen, A, Verhoeven, AC, Verbeek, JH, van der Feltz-Cornelis, CMInterventions to improve occupational health in depressed people. Cochrane Database Syst Rev 2008;2:CD006237. doi(2):CD006237.CrossRefGoogle ScholarPubMed
Ormel, J, Vonkorff, M, Oldehinkel, AJ, Simon, G, Tiemens, BG, Ustun, TBOnset of disability in depressed and non-depressed primary care patients. Psychol Med 1999;29(4):847–853.CrossRefGoogle ScholarPubMed
Riihimaki, KA, Vuorilehto, MS, Melartin, TK, Isometsa, ETFive-year outcome of major depressive disorder in primary health care. Psychol Med 2011; 16: 1–11.Google Scholar
Rost, KDisability from depression: the public health challenge to primary care. Nord J Psychiatry 2009;63(1):17–21.CrossRefGoogle ScholarPubMed
Rytsala, HJ, Melartin, TK, Leskela, US, Sokero, TP, Lestela-Mielonen, PS, Isometsa, ETFunctional and work disability in major depressive disorder. J Nerv Ment Dis. 2005;193(3):189–195.Google ScholarPubMed
Rytsala, HJ, Melartin, TK, Leskela, US, Lestela-Mielonen, PS, Sokero, TP, Isometsa, ETDeterminants of functional disability and social adjustment in major depressive disorder: a prospective study. J Nerv Ment Dis 2006;194(8):570–576.Google ScholarPubMed
Rytsala, HJ, Melartin, TK, Leskela, US, Sokero, TP, Lestela-Mielonen, PS, Isometsa, ETPredictors of long-term work disability in major depressive disorder: a prospective study. Acta Psychiatr Scand 2007;115(3):206–213.CrossRefGoogle ScholarPubMed
Salminen, JK, Saarijarvi, S, Raitasalo, RDepression and disability pension in Finland. Acta Psychiatr Scand 1997;95(3):242–243.CrossRefGoogle ScholarPubMed
Sartorius, N, Ustun, TB, Costa e Silva, JA, Goldberg, D, Lecrubier, Y, Ormel, J, et al.An international study of psychological problems in primary care. Preliminary report from the World Health Organization Collaborative Project on ‘Psychological Problems in General Health Care’. Arch Gen Psychiatry 1993;50(10):819–824.CrossRefGoogle Scholar
Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR, Grant, MDevelopment of the alcohol use disorders identification test (AUDIT): WHO Collaborative Project on early detection of persons with harmful alcohol consumption – II. Addiction 1993;88(6):791–804.CrossRefGoogle ScholarPubMed
Sheehan, KH, Sheehan, DVAssessing treatment effects in clinical trials with the Discan metric of the Sheehan Disability Scale. Int Clin Psychopharmacol 2008;23(2):70–83.CrossRefGoogle ScholarPubMed
Simon, GE, Revicki, D, Heiligenstein, J, Grothaus, L, VonKorff, M, Katon, WJ, et al.Recovery from depression, work productivity, and health care costs among primary care patients. Gen Hosp Psychiatry 2000;22(3):153–162.CrossRefGoogle ScholarPubMed
Simon, GE, Barber, C, Birnbaum, HG, Frank, RG, Greenberg, PE, Rose, RM, et al.Depression and work productivity: the comparative costs of treatment versus non-treatment. J Occup Environ Med 2001;43(1):2–9.CrossRefGoogle Scholar
Sorvaniemi, M, Helenius, H, Salokangas, RKFactors associated with being granted a pension among psychiatric outpatients with major depression. J Affect Disord 2003;75(1):43–48.CrossRefGoogle ScholarPubMed
Sorvaniemi, M, Helenius, H, Salokangas, RKSick-leave certificates granted to psychiatric outpatients with major depression. Depress Anxiety 2003;17(4):220–223.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JB, Kroenke, K, Linzer, M, deGruy, FV, Hahn, SR, et al.Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. 3rd. JAMA 1994;272(22):1749–1756.CrossRefGoogle ScholarPubMed
Stewart, AL, Sherbourne, CD, Wells, KB, Burnam, MA, Rogers, WH, Hays, RD, et al.Do depressed patients in different treatment settings have different levels of well-being and functioning?. J Consult Clin Psychol 1993;61(5):849–857.CrossRefGoogle ScholarPubMed
Thomas, CM, Morris, SCost of depression among adults in England in 2000. Br J Psychiatry 2003; 183: 514–519CrossRefGoogle ScholarPubMed
Vos, T, Haby, MM, Barendregt, JJ, Kruijshaar, M, Corry, J, Andrews, GThe burden of major depression avoidable by longer-term treatment strategies. Arch Gen Psychiatry 2004;61(11):1097–1103.CrossRefGoogle ScholarPubMed
Vuorilehto, M, Melartin, T, Isometsa, EDepressive disorders in primary care: recurrent, chronic, and co-morbid. Psychol Med 2005;35(5):673–682.CrossRefGoogle ScholarPubMed
Vuorilehto, MS, Melartin, TK, Rytsala, HJ, Isometsa, ETDo rightacteristics of patients with major depressive disorder differ between primary and psychiatric care?. Psychol Med 2007;37(6):893–904.CrossRefGoogle ScholarPubMed
Vuorilehto, MS, Melartin, TK, Isometsa, ETCourse and outcome of depressive disorders in primary care: a prospective 18-month study. Psychol Med 2009;39(10):1697–1707.CrossRefGoogle ScholarPubMed
Wells, KB, Sherbourne, CDFunctioning and utility for current health of patients with depression or chronic medical conditions in managed, primary care practices. Arch Gen Psychiatry 1999;56(10):897–904.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.